Smart Service Application Form
Smart Service Application Form
Complete Form & Signed Subscriber Declaration Company ID (Front and Back)
Certificate of Employment / 1 Month Latest Payslip (if with date hired/employee status) Primary Government Issued ID
Fill in all the required inform ation. Do not leave an item blank. If item is not applicable, indicate "N/A"
Kindly write legibly and countersign any erasures.
*Required SUBSCRIBER INFORMATION
Mobile Min for Retention
NEW CONNECT RETENTION
SUBSCRIBER NAME: (Last Name/ First Name/ Middle Name)
BIRTHDATE: (MM/DD/YYYY)
MOBILE NUMBER:
Shade or Mark (x, ) Your Preferred Postpaid Kit Delivery Address: Office Residence - Please attach Proof of Billing
PLAN DETAILS PLAN 500 PLAN 1000 PLAN 1500 PLAN 2000 PLAN 2500
Quantity
Handset Model
Monthly Amortization
Total MSF
One Time Cashout na na na na na
Contract Term (Mos) 24mos 24mos 24mos 24mos 24mos
Notes:
INCLUSIONS
Calls to Smart Unlimited Unlimited Unlimited Unlimited Unlimited
Calls to Sun Unlimited Unlimited Unlimited Unlimited Unlimited
Internet (Local) 2GB 6GB 10GB 40GB 70GB
Calls to All Mobile Networks (Mins) Unlimited Unlimited Unlimited Unlimited Unlimited
Calls to All Landline Unlimited Unlimited Unlimited Unlimited Unlimited
SMS to All Networks Unlimited Unlimited Unlimited Unlimited Unlimited
RATES (VAT inc.) NEAREST RELATIVE INFORMATION *
Voice SMS Name:
On- Net P5.00 On- Net P0.50 Relationship:
Off- Net P5.00 Off- Net P0.50 Address:
Landline P5.00 MMS
International On- Net P1.00
SMS P10 Off- Net P2.00
Voice ($ Rate) USD 0.40 Data Mobile Number:
KB P0.05/KB Landline No:
FO R S MART'S US E O NLY
EE Personnel/Admin Credit Officer Validations Officer
Name
Signature
Status/Remarks
*Required
I affirm that the above given info rmation and suppo rting documents are true and correct. I understand that I may be requested to submit requirements to facilitate the pro cessing o f this applicatio n. I signify agreement to the above
pro visio ns,
T E R M S A N D C ON D IT ION S and the e-SOA set forth, fo und in this application fo rm.