DocuSign Envelope ID: 3C1DF31C-68CA-40B3-887E-080B12E2982B

CUSTOMER’S INFORMATION/TAARIFA ZA MTEJA

Registered Name: …………………….........................................…...........…… Accounts Person: ………………………………….............................………………......

Jina la Usajili: Mhusika wa masuala ya fedha:

TIN number: ………………………................................….……......................…. Customer type: ………………………………….............................………………...........

Namba ya TIN: Aina ya Mteja:

Contact Person: ………………………….......………......................…........……….. Email Address:…………………………………….……………………….……………………….…

Mwakilishi wa Kampuni: Barua pepe:

Physical Address: ………………………......………..............................…………... Main Contact Number:……………………………………………………….……………….

Anuani ya Eneo: Namba ya simu ya mkononi:
Next of kin Number:…………………………….Relationship………………………
Namba ya mtu wa karibu Uhusiano

SERVICE TYPE AND MONTHLY COSTS/AINA YA HUDUMA NA MALIPO YA KILA MWEZI

Product Name (Unlimited Main Stable Power
Price Points Site Name MISISDN Number Site Coordinates
internet, no data cap) on Site (Yes/No)
Up to 20Mbps (4G only) TZS 115,000.00
Up to 30Mbps TZS 120,000.00
Up to 50 Mbps TZS 150,000.00
Up to 100 Mbps TZS 250,000.00
Up to 200 Mbps TZS 400,000.00
Up to 350 Mbps TZS 600,000.00

TICK DEVICE TYPE DEVICE DETAILS TICK CATEGORY OF USAGE

4G 5G IMEI NUMBER Home use (Individual) Enterprise

In case of early termination of Agreement before 24months, costs of device provided for connection have to be paid to Vodacom. A security deposit worth two months
charges is to be paid before service activation, to be refunded on termination or expiration of contract if there is no defaulting on payment terms.
Ukivunja mkataba kabla ya miezi 24,utalipia gharama ya kifaa ulichopewa kwaajili ya Internet sawa na thamani yake halisi. Dhamana ya usalama yenye thamani ya malipo
ya miezi miwili lazima ilipwe kabla ya kupokea huduma, na itarejeshwa kwa kuvunjwa au kumalizika kwa mkataba ikiwa hakuna kukiukwa kwa masharti ya malipo.
DECLARATION /Tamko.
BY SIGNING BELOW,WE ACKNOWLEDGE AND AGREE THAT WE HAVE FULLY READ, UNDERSTOOD AND VOLUNTARILY ENTER INTO THIS AGREEMENT AND WE DECLARE THE ABOVE INFORMATION TO
BE TRUE AND CORRECT. WE AGREE TO SUBSCRIBE AND UNDERTAKE TO PAY ALL FEES AND CHARGES. WE ALSO HEREBY ACKNOWLEDGE RECEIPT OF EQUIPMENT FOR VODACOM SERVICES WHICH ARE
NON TRANSFERABLE AND WE AUTHORISE AND GIVE CONSENT TO VODACOM PLC TO VERIFY THIS INFORMATION. WE FURTHER CONSENT TO THE TERMS AND CONDITIONS AND PRIVACY POLICY
AVAILABLE ON HYPERLINK https://vodacom.co.tz/supakasi . WHICH ARE INCORPORATED BY REFERENCE AND MADE A PART OF THIS AGREEMENT AS THOUGH FULLY SET FORTH HEREIN.

Kwa kutia saini hapa chini, unakubali kuwa umesoma na kuelewa kikamilifu na kwa hiari umeingia kwenye makubaliano na unahakiki kuwa taarifa ulizotoa hapo juu ni za
ukweli na sahihi. Umekubali kujiunga na kulipa ada na tozo zote. Pia unakiri kupokea vifaa vya huduma za Vodacom visivyohamishika na unaruhusu na kutoa ridhaa kwa
Vodacom PLC kuhakiki hizi taarifa. Umetupa ridhaa ya kukubaliana na sheria na masharti ya faragha yanayopatikana kwenye hiki kiunga https://vodacom.co.tz/supakasi
ambayo yamewekwa kulingana na makubaliano haya.
ON BEHALF OF VODACOM /Kwa niaba ya Vodacom
SIGNATORY NAME .................................................................................................................. Issa Orry
SIGNATORY NAME ..................................................................................................................
Mtiaji saini: Mtiaji saini:

AUTHORIZED SIGNATURE/................................................................................................... AUTHORIZED SIGNATURE/...................................................................................................

Saini: Saini:
DATE/............................................................................................................................................. DATE/.............................................................................................................................................
Tarehe: Tarehe:

OFFICIAL USE ONLY Vodacom Tanzania Public Limited Company, Phone: +255 754 705 000
KWA MATUMIZI RASMI TU 15 Floor, Vodacom Tower, Ursino Estate, E-mail: info@vodacom.co.tz
Plot No. 23, Bagamoyo Road,
Partner Name/Jina la Mshirika P. O. Box 2369, Dar es Salaam, Tanzania.
vodacom.co.tz

Directors: TB Mihayo* (Chairman), D Gutierrez******, H Bujiku(FD)*, K Mutooni**, M Ikongo*, M Mbungela****, N Nyoka****, P Besiimire(MD)***** R Morathi****, S Ramasamy*******, S Mdlalose Please Initial
*** T Semane**** Company Secretary: C. Mduma*[*Tanzanian, ** Kenyan, *** British, ****South African, *****Ugandan, ******Bolivian, *******Indian] Reg. No. 38501