Renewal Form – Residential Broadband

ACCOUNT DETAILS
SECTION A: SERVICE PLAN
Service Location: All location /High Rise

Please indicate where applicable: 1st Year

SERVICE PLAN
FreshHB Contract 12 Months 24 Months (One Time Deal) 24 Months

50 Mbps Renewal RM89 □ RM79 □ N/A

100 Mbps Renewal RM99 □ RM79 □ N/A
200 Mbps Renewal RM129 □ RM99 □*** RM 1,600 □****
300 Mbps Renewal RM149 □ RM119 □*** RM 2,200 □****
500 Mbps Renewal RM179 □ RM 149 □*** RM 2,800 □****
*Voice / Phone service upon request only ***Mesh router **** Inclusive SST

SECTION B: DOCUMENT REQUIRED

Please indicate where applicable:

⌦ □ NRIC (for Malaysian) □ Passport (for Non-Malaysian)

Provide a copy of:
S&P 1st pg/ VP letter
□ □ SSM Documents for Company
Bank Detail : Hong Leong Berhad / 236 0056 2859 / Freshtel Internet Sdn Bhd (Non-Malaysian require RM500 deposit upon submission)

SECTION C: CUSTOMER INFORMATION

Account Name Company Reg No.

Trade Name NRIC / Passport No.
(If Any )
Installation Unit Block Level Unit

Person In Charge Mobile No

Email Address
Prefer Installation Agent Code

SECTION D: BILLING INFORMATION

Person In Charge Mobile No

Email Address
*This email will assign as User ID for Freshtel portal and Monthly billing statement will be sent via this email.

Billing Address

Lot 11, 2nd Floor, Millerz Square @ Old Klang Road, No. 357,
Jalan Kelang Lama, 57000 Kuala Lumpur.
Website : https://www.freshtel.my
03-9078 2963 hello@freshtel.my support@freshtel.my

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SECTION E: CUSTOMER ACKNOWLEDGMENT
ACKNOWLEDGMENT

I, NRIC / Passport Number hereby

accept any and all responsibility for the installation of Freshtel’s service and I understand and agree to accept and be bound by the terms
and conditions (https://www.freshtel.my) which accompany the usage of the Freshtel service. The terms and conditions are subject to change
by Freshtel Internet Sdn Bhd (Formerly known as Freshtel Group Sdn Bhd). I will be notified in a manner where necessary and appropriate. I
confirm that the information given herein is correct and accurate. I understand Freshtel reserves the right to verify any information provided
by me concerning this application.

Contract Period / Termination / Refund

The Service will continue automatically upon expiry of the Contract Period on a month-to-month basis unless otherwise terminated by me in
writing or official. The penalty will be charged if I Terminate the Service before the expiry of the Contract Period if any. Deposit refund (if
any) will be 45 working days after the termination date (last date of the service month) and after returning all the devices to Freshtel. Payment
advance (if any) only can be converted on last month usage. Refund will be returned to the account holder name only. If I fail to return the
equipment in a good working condition to Freshtel Internet's designated drop-off area upon the termination accepted, the Company has the
right to impose an RM400.00 fee to me as the compensation fee to the faulty or missing equipment.

Consent
In according to the Credit Reporting Agencies Act 2010 and Central Bank of Malaysia Act 2009, I/we the undersigned, do hereby irrevocably
and unconditionally give consent to you, your appointed registered credit reporting agency(ies) and/or any debts collecting agency(ies)
appointed by you to process my/our companies and personal data such as conducting credit/trade check, CTOS and DCHEQS checks on me/us
and where applicable, our director(s), shareholder(s), and guarantor(s) [collectively the "Parties"], with your appointed registered credit
reporting agency(ies) and/or debts collecting agency(ies) appointed by you at any time for as long as the Parties have a trade relationship
with you or where any dues remain unpaid and outstanding with you for the purposes of, (a) opening of the account; (b) debt recovery; (c)
credit/account review; (d) legal documentation consequent to a contract or facility granted by you; (e) credit/account monitoring and (f)
credit/account evaluation. You and/or your appointed debts collecting agency(ies) may disclose any information on the Parties conduct of
their accounts with you to any business entity(ies) for bona fide trade checking at any time. The Parties are also aware and understand that
such information will be provided to your credit reporting agency(ies) and/or debts collecting agency(ies), who may, in turn, share such
information to subscribers of their Service. Where you require any processing of our application to be processed by any processing centre
located outside Malaysia (including your Head Office), the Parties hereby give consent to your appointed registered credit reporting
agency(ies) and/or debts collecting agency(ies) to disclose their credit reports to such locations outside Malaysia. Apart from that, the Parties
undersigned give my/our consent to you and your appointed registered credit reporting agency(ies) and/or your debts collecting agency(ies),
to process my/our personal data as per the Personal Data Protection Act.

Service
I understand I am provisioned with high-speed internet access from my home, either with or without a voice service, based on the plan that
I have subscribed to in the registration form. I am aware that the package detail is available on https://portal.freshtel.my/plan-package-
adviser; Freshtel Internet may change the plans periodically, but such change does not change the Service I have subscribed. The Service is a
personal fixed high-speed internet access that enables me to access the world wide web and any offerings or services available thereon, but
I will be responsible for the risk whenever I am accessing these services. Freshtel Internet Sdn Bhd will provide me with a Service comprising
standard service components: an Optical Network Unit ("ONU") and a Wi-FI router. I understand Freshtel Internet Sdn Bhd aims to provide
a continuous, high-quality service using reasonable care and skill on a best efforts basis. However, I understand Freshtel Internet Sdn Bhd
can't guarantee that it'll be available all the time due to the nature of the Service and the Service Equipment Freshtel Internet Sdn Bhd uses
to provide the Services.

CUSTOMER SIGNATURE / COMPANY STAMP DATE OF APPLICATION

SECTION F:REFERRAL INFORMATION

Referral Name : Mobile No.

Remarks :

FOR FRESHTEL USE ONLY

Assigned Account Code

Verified by: Verified Date: Completed

Lot 11, 2nd Floor, Millerz Square @ Old Klang Road, No. 357,
Jalan Kelang Lama, 57000 Kuala Lumpur.
Website : https://www.freshtel.my
03-9078 2963 hello@freshtel.my support@freshtel.my

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