Date ______________________

PLDT, Inc.
Ramon Cojuangco Building
Makati Avenue, Makati City

Attention: < S/RM / CRA Full Name>

Position / Title

This is to request for Voluntary Temporary Disconnection (VTD) of the following:

Type of Service Billing Account Number

With below reason. VTD shall start from ________________ and end on ______________.

Building Expansion/Renovation
Fortuitous Event (specify details)
Transfer of Location (unavailability of Service)
Dispute
Clean-up
Others: < Specify and explain the reason >

In view of this, I abide to comply with the Business Guidelines covering this VTD
agreement:
1. We shall properly notify (name of S/RM / CRA) _______________ a month prior
to the extension of our VTD agreement via a letter or an email.
2. We shall settle all unbilled Toll Usages incurred prior to VTD implementation
and within the VTD period.

Thank you for your kind attention on this matter.

Very truly yours,

<Signature over printed name>

Customer name
Position Title
Company