Date of Application: PERSONAL INFORMATION WHERE CAN WE CONTACT YOU? ultname wai as-ns new My contac otal shallbe used subject to the Subserber's Deeraton fice/Business Nur E-moil Address Nickname Birthday #900 Mobite Number Home Number Mothers Maiden lame In case we can't reach you who else ean we contac for 3 pplication evaluation? Home Adaress , Complete Name - a Contact Number Relation ‘Nearest Landmark ioap srt gona loa WORK INFORMATION pa i | Offce/Business Name | Office/ausines Address i Gender | Owe Qrerte | 10 — | owt ats saeco rpebatn Ce ane | Cha Sconpan 0 curentaob Te ony Income a Length of Service wth Curent ployer! Business owes Oss (OTHER GOVERNMENT IDs a nants ctzenp - Start Date of Employment/Business (mm/dd/yy) ace 2 eke een beeen © ovrot-contact ‘statements and other Smt Signature service notifia © tanyRetenton femsining Monts: Please downlond the Gigalite App to easily view your billing Name of Subscriber - . — Mobile No. Consent to take photos @) rotoke Account No, ture of my requeements and ferthe Company to mainton Plan Description Contact Ena Date Date Time T x smart Sranch Nei Contract Star Ost eee Soures ot Appietion: (C) Inbound Oortooune New Contact End Date ‘Soles Representatives NameRTE Oren tatAUTOMATIC DEBIT AGREEMENT TERMS AND CONDITIONS 1. For purposes ofthe Automatic Debit Agreement, the words “wer “‘me" and "my" shel refer tothe Subseriber wale the ors "you and your shall refer to Smart Communications, Tre SiMART| My enrollment to the Automatic Debit Agreement (ADA) shall take effect upon approval of the issuing bank or _equiing bank, and SMART. Upon the approval of my eerellment to the ADA, | hereby authodize SMART to automaticaly charge my total account balances to my envolled credit card, on a monthly basis. Provides tha incase the crest card biting charge submitted by SMART tothe issuing bank or acquiring bank rejected cr cdecingd for any reason whatsoever, SMART may si attempt to sutimit the same biling charge to the issuing bank or acquiting bank until the total account balance for the bling period necomes avaliable 4. Balances that are sil cutstanding pri to my application for tenliment to the ADA may be charged by SMART to my Crest card upon approvatot my ADA enrollment, 5. Inthe event thatthe ereaigard biling charge suorited by SMART tothe issuing bank oF acquting bank is rejected or ecined for any reason or whatsoever, | shall settle my ulstanding bance directly with SMART er through SMART’ accredited payment channels, 6. understand thas in case of changes in my creat cara number brought about by cases, such a5, but not Limite to, lost credit cord, upgrade ond/or card renewal, | shall 6¢ ‘tequirad to submmit'a new ADA Enrolment Form indicating ‘these changes. | understand that in case of changes in my credit card expiry date, brought about by cases, such as, but ‘ot inte to card renewal, shall be required to repor the new expiry date of my enrolled creditcard to your customer service, In case fall repor the new credit cara expiy date land my enrolled crect card is already expired, SMAAT shal fenideavor to ty to update the new expiy date to be able to ‘continue the submission of my biling enarge tothe suing bank orthe acquiring bank Provided however, nat, shale held lable for any inconvenience orceay of my payments should the credit card company decline the ansaction due to the changes in my credt card number andfor crest care ‘expiry date which are not reported to you “7 Vunderstand tnatin ease of changes in my mobile number or ‘account number brought about by cases, such 83, But not limited to, change in ownership of account migration to oF from any of the SMART Postaaid services, | shall be required to submit a new ADA Enrollment Fotm ingicating these changes 8. | understand that at any time, SMART may initiate the ‘cancellation of my enrollment to the ADA, for any reason whatsoever. In case of such cancelation, of any other cancelation for any reason whatsoever, | shall pay my Bits directly to SMART oF though SMART's aceredited payment channels. Any amount due prior to the effective date of fuch cancellation shal stl be dus and demandaba and may {tl be submitted by SMART Wo the issuing bank oF acquiting bank for approval prior to the effective date of the cancelation 9. fully understan thet my enrliment to the ADA may ent my account to exemptions from the preredirecton and redirection services even when my usage has exceeded the assigned crect limit forrny account lundertae to nave read, understood ana agrees tothe Terms and. Conaitions governing the Automatic Debit Agreement (ADA as evidenced by my signature in this Application Form iene CARD HOLDER INFORMATION card ry ba SMART ACCOUNT INFORMATION Account Number being ems poamanaaton? Ose OM Spon Sanegtoln, Ue sgn apeaner me seme aS. Hoeren ‘Sins Gcpemera furs saris hope om Cardholders signature over printed name Datei. 0D-¥ ‘Subscribers sgnatue aver pntsd name Date E.VVY ‘SUPPLEMENTAL TERMS TO THE AUTOMATIC DEBIT AGREEMENT “hisunderaingicony appeaewnenenlinento Rt Debt green ieee we nae onpare scan anon Acoma "nde to go SUART nance te cau eget ft my New Line “Een yen ore St ear ppm eet ~Serpatecmaob emrcanet aghyree tice ateeuk ecu | This is to dectare that | have read and accepted the Sulbscriber's Declaration and hereby consentUackrowledge that_my acceptance will carry over/cover all applicable tne applications herewith Subscriver’s signature over printed name Pian - Device: Mobile No.: — Plan - Device _ Mobile No.IT'S SIMPLE TO © ae 12 months ! PHP599_ | PHP999 PHP 1499 PHP 1999 PHP 2499 20GB 40GB 60GB UNLI ote 5os UNLF for 6 Months 4g/56 Cait Unli AllNet** Mobile Calls and Landline Calls Texts Unli AltNet* Subscription Netfix Mobile Plan Rae ea cae 0) @ 0) 0® a 24 months sal PHP 599 PHP 999 PHP 1499 PHP 1999 PHP 2999, Data 2.5GB 5GB 10GB 15GB 30GB coils 25 Mins PLOT 80 Mins PLOT 100Mins PLOT | 150Mins PLOT | 300 Mins PLOT Unli AlINet** Mobile Calls Unii AllNet** Texts ere ee ees ieee toca Ao 2 Prone Device (_) Onetine Cosreut | (-}acup tom Ts Ste Pekup om ther Str Bro (Corect Detvery Shiga Ades: Device Amortization | PL Free SRE Ieee ronment Al Smar/Sun/TNT/ebe/TH/DITO ether mabe eee aes dae) Chasen Plan ‘Chosen Device TOTAL MONTHLY FEE Commitment Period Promo Availed Wah fo know more about t sna sense | Avie 7) tematic att Agrement —() igi ho to se-op ond we te ial pp = Osastnage tomanage my Sonstre gin. zi =a Ask us ho Dae ne a NETFLIX | Spotify PHP 149 Mobile / PHP 369 Basie / | HBOGO "8°00 | spotty PHP 149 Spotty Premium / PHP 169 PHP 459 Stand / PHP 59 Premium Premium Dv / PHP 214 Premium FoiSmart sun ‘CUSTOMER NAME: APPLICATION TYPE: MANNER OF RELEASE: SOURCE OF APPLICATION: — Walkin © Outbouna Py eee) Bitte Wl Additional Line Ml Availed via Promotior ISIMOnly —_OWithDevice 0 Device Financing Plan Appliod: Devi NEW CONNECT AND RETENTION VALIDATION CHECKLIST TinStore c Direct Delivery 0 Other Store Events/aitztners: part CART ID NUMBER: ACCOUNT NUMBER: SO NUMBER: Branch, Agent: Retention MIN - Retention Type | ed Scientia’ Device: Gost: © Freebie: Cost: Freebie: Number of requited AMSF: "AMSF Amount: ‘Name of Financing Partner: Promo/Event Code: (1 specimen Signature ©. Same plan [O_Change Pian PromolEvent Cod: “From: 1 All Signatures matched (ID, Application, Specimen) With manval email validation (emails not ston validated) [All documents are vouched received via customer's decared emoilodarens and _| sigoed bythe sales personnel For infinky RM) Financial Documents: ‘others: All documents are vouched Seen Original and signed by the sales personnel SEMI Correctly and Completely filed out Application Form {for Physical SAF) Checked Fraud Gallery Ref Credit Match wi Cross Checking and Blacklist With Related Smart and/or Sun Accountls? All information encoded are consistent with the documents submitted and that of the related accounts 1 not, necessary correction should be performed prior to encoding Findings: aw: MIN: Remarks: Performed By (if Outbouna): Brand: Brand : ‘status: Aging : aging Sales Personnel 1 Performed Credit Match Documentary requirements are complete and valid 1 Financial Document is within allowable offer [Consistent information with other related accounts ‘Customer Information encoded is: [2 Compliant withthe Encoding Standards Consistent with documentary requirements [Email Address is validated, If not, attached manual email validation Dates ‘Contact number Fist Party Callout Name ‘Second Pay Cal-out ‘Name: Callout Result TALL OUT TPS 4" Employment Veriteation: Beto cal the Trunking, alvays ask lo the HR parr ny king fr cher sou of coat rumba, 2 Supplementary callout Ask fr olatcnsie tee apleant.spican's adore, tv stake, serce ction, Role down che dela nnd inthe application, 3. For wale of lout fil ot and perforate testatlon ath betony CREDIT EVALUATION DECISION: DApproved —-GRequireDocs Remove Product Reject. Require Deposit Remarks: Approved by? Date: ‘Wame and Signature) Standard Approver's Remarks: 3: (Should incluce all application cetals ie, Plan, ANSF, Device, Intal Cashout, Promo Cade, Special Notations) (ate, Name Contacted, Contact number, Call ou details) Post Reviewed by: Date; FP RRR CALIF a This sto atest hatte customer appiyng for Posipal Plan was personaly seen, cod, emsiled, 28 applicable and inferdewed by me dring the application and submission of documentary requirements. Furthermore, I have validated and confrmed wih th customer that all des and contact Information In the Physical Subscriber Apptcation Form aro correct and complat. 1 Nave also explained to the custoror tat all contact numbers that were provided dering pplication including sternate contact numbers wil be used fr call-out alan, ‘Sales Personne! (Name ana Signature) _Approver tame and Signatre) ‘customer (ame and Signature) Note: For Outbound Sales actviy callout may be waived the approve is onsite and has personally seen the customer, heshe shal sign the attestation,