REQUIREMENTS CHECKLIST

(For email applications: EnterpriseExtension@smart.com.ph)

Complete Form Company ID (Front and Back)

Gov't ID with signature (if company ID does not reflect employee signature)
Certificate of Employment or 1 Month Latest Payslip (if with date hired/employee status)

New Connect Retention

SERVICE APPLICATION FORM This fie ld is for Re te ntion only

Mobile Numbe r:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

ENTERPRISE EXTENSION v.2 Da te Hire d:_ _ _ _ _ _ _ _ _ _ _ _ _ _

Employe e # :_ _ _ _ _ _ _ _ _ _ _ _ _

Fill in all the required information. Do not leave an item blank. If item is not applicable, indicate "N/A"
Kindly write legibly and countersign any erasures.
*Required SUBSCRIBER INFORMATION
SUBSCRIBER NAME: (Last Name/ First Name/ Middle Name)

BIRTHDATE: (MM/DD/YYYY)

RESIDENCE TEL. NUMBER: BUSINESS NUMBER:

MOBILE NUMBER:

ACTIVE EMAIL ADDRESS: (default e-SOA email address) *

COMPANY/BUSINESS NAME: Position Title:

Shade or Mark (x,✔) Your Preferred Postpaid Kit Delivery Address: Business Residence

BUSINESS ADDRESS (Building, Street, Baranggay, City/Province/Zip code): *Required

RESIDENCE ADDRESS (Building,Street,Baranggay,City/Province/Zip Code): *Required

PLAN: _________
PLAN DETAILS PLAN 500 PLAN 1000 PLAN 1500 PLAN 2000
Option Additional
Quantity
Handset Model
Color
Monthly Amortization
One Time Cashout na na na na
Contract Term (Mos) 24 24 24 24
Notes:
INCLUSIONS Ind icat e Inclusio ns b elo w:

Calls to Smart Unlimited Unlimited Unlimited Unlimited

Calls to Sun Unlimited Unlimited Unlimited Unlimited
Internet (Local) 2GB 5GB Non-stop surf Non-stop surf
Calls to All Networks (Mins) na 50 Mins. 100 Mins. 150 Mins.
SMS to All Networks 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:
FOR S MART'S US E ONLY
EE Personnel/Admin Credit Officer Validations Officer
Name
Signature
Status/Remarks
*Required

I affirm that the abo ve given info rmatio n and suppo rting z
do cuments are true and co rrect. I understand that I may be requested to submit requirements to facilitate the pro cessing of this applicatio n. I signify agreement
to the abo ve pro visio ns, T ER M S A N D C ON D IT ION S and the e-SOA set fo rth, fo und in this applicatio n fo rm.

Subscriber's Signature ov er Printed Name / Date Signed