BUSINESS APPLICATION FORM: MOBILE/MOBILE BROADBAND SERVICE

M2 Commander Pty Ltd ABN 85 136 950 082 Level 10, 452 Flinders Street, Melbourne VIC 3000 F 03 9674 6599 W commander.com.au

Company Name - Legal and Trading Name if applicable (of full name for individuals): Application Date (dd/mm/yy):

MOBILE/MOBILE BROADBAND SERVICE Campaign/Promo Code:

Existing Mobile Mobile/ Current Current Provider User Plan Plan SIM Device Device Monthly Contract Minimum
Number/New Service: MBB: Provider: Account No./ DOB^: Name: Name: Monthly Required Make/Model: Repayment Term Payable Over
Access Fee : (Y/N) Option $: (mths): Contract*:

^Date of Birth (DOB) is required when porting Prepaid services to Commander. Total Minimum Payable
*Minimum Payable Over Contract includes the Plan Monthly Access Fee, plus any optional Device Monthly Repayment Option (MRO), multiplied by the Contract Term. Over Contract*:

LEGEND:
MBB: Mobile Broadband Is an Additional Services Application attached? Yes No Is price subject to a bundled services offer? Yes No
DELIVERY DETAILS
Street / Service Address (inc. unit no./suite no.): CUSTOMER PORTING AUTHORISATION: I declare that I have a contractual right to the MSN(s) shown above and am authorised to request porting of the MSN(s). I acknowledge that I have
been advised that by Porting the MSN(s), any services and/or Related Services associated with the MSN(s) may or may not be disconnected from the Losing Service Provider and may result in
finalisation of the account for the service(s). I authorise the MSN, the Gaining Service Provider and the Network Type to be disclosed to other Network Provider and portability Service Suppliers
for the purpose of routing of calls, customer network fault management and routing of SMS messages to that MSN after porting activity. I acknowledge that I have been advised by Commander
Street / Service Address (inc. unit no./suite no.): that if I continue to use the existing handset, it may need to be unlocked and/or reprogrammed prior to porting.

CUSTOMER ACKNOWLEDGEMENT: I acknowledge that I have been advised by Commander that although I may have the right to Port the MSN(s), there may be costs and obligations
associated with the existing mobile service(s) and Porting the Mobile Service Number(s). I may or may not be in an existing contract with the current Carriage Service Provider(s). The contract
Suburb: State: Postcode: may or may not include an obligation to make early termination payments to the current Carriage Service Provider(s).

I consent to the above email address and my personal information being used for the delivery of invoices, notications and marketing material from Commander and its related bodies
corporate and partners. For further information about how we collect and disclose your personal information, please see our Privacy Policy and Privacy Collection Statement on our
Contact Name(s): website.

Contact Number: Signature of Applicant: Init: Date:

All Enquiries 132 777 salesquery@commander.com COMM_I03_0001_BAF_Rebrand_Feb19_Mobile/MobileBroadband