Residential BroadbandHigh-Rise Registration | Renewal | Upgrade Form

SECTION A: APPLICATION TYPE

Please indicate where applicable:

🛈 Application Type: Registration Upgrade Renewal

SECTION B: SERVICE PLAN

Please indicate where applicable:

HFI connect Bandwidth HFI connect

No Contract 12 Months 24 Months
RM150 (refundable) + RM150 (installation)

50Mbps RM89 RM79 RM69

100 Mbps RM99 RM99 RM79
200 Mbps - RM129 **RM99
300 Mbps - RM149 **RM119
*500Mbps - RM179 **RM149
Phone Line Yes / No
RM20 (Monthly) RM250 | One ľime Puíchase
Mesh Router
*500Mbps is available in certain location only **24 Months with Mesh Router *** All prices subject to 6% SST

SECTION C: PROMO CODE

Promo Code
MCG2024
SECTION D: DOCUMENT REQUIRED

Please indicate where applicable:

🛈 Provide a copy of: NRIC (Malaysian) Passport (non-Malaysian) / Deposit RM500

Bank Details: Hong Leong Bank Berhad / 236 0056 2859 - Freshtel Internet Sdn Bhd

SECTION E: CUSTOMER INFORMATION

Customer Name MOHD AIDIL BIN OTHMAN NRIC / Passport No. 901224016035
Installation Address B-13A-13 RESIDENSI AWANI 3, NO 2, JALAN SANTUAR I 2

Postcode 53200 City SETAPAK State W.P KUALA LUMPUR

Telephone No Mobile No 011-18808557

Email Address AidilMohd1990@gmail.com

Agent Code(if any)

1 | Page FRESHTEL INTERNET SDN BHD (1154469-D) FT/FORM/FHB21112024

¡˙•Lot 11, 2nd Flooí, Milleíz Squaíe @ Old Klang Road, No. 357, Jalan Kelang Lama, 57000 Kuala Lumpuí.
Website : https://www.fíeshtel.my | \!03-9078 2963 | □V□V hello@fíeshtel.my □□ VV
 SECTION F: CUSTOMER ACKNOWLEDGMENT
I, MOHD AIDIL BIN OTHMAN NRIC / Passport Number 901224016035 hereby accept any and all responsibility for the installation of
Freshtel’s service and I understand and agree to accept and be bound by the terms and conditions (https://www.freshtel.my) which
accompany the usage of the Freshtel service. The terms and conditions are subject to change by Freshtel Internet Sdn Bhd (Formerly
known as Freshtel Group Sdn Bhd). I will be notified in a manner where necessary and appropriate. I confirm that the information given
herein is correct and accurate. I understand Freshtel reserves the right to verify any information provided by me concerning this
application.

Contract Period / Termination / Refund

The Service will continue automatically upon expiry of the Contract Period on a month to month basis unless otherwise terminated by me
in writing or official. The penalty will be charged if I Terminate the Service before the expiry of the Contract Period if any. Deposit refund (if
any) will be 45 working days after the termination date (last date of the service month) and after returning all the devices to Freshtel.
Payment advance (if any) only can be converted on last month usage. Refund will be returned to the account holder name only. If I fail to
return the equipment in a good working condition to Freshtel Internet's designated drop-off area upon the termination accepted, the
Company has the right to impose an RM400.00 fee to me as the compensation fee to the faulty or missing equipment.

Consent
In according to the Credit Reporting Agencies Act 2010 and Central Bank of Malaysia Act 2009, I/we the undersigned, do hereby irrevocably
and unconditionally give consent to you, your appointed registered credit reporting agency(ies) and/or any debts collecting agency(ies)
appointed by you to process my/our companies and personal data such as conducting credit/trade check, CTOS and DCHEQS checks on
me/us and where applicable, our director(s), shareholder(s), and guarantor(s) [collectively the "Parties"], with your appointed registered
credit reporting agency(ies) and/or debts collecting agency(ies) appointed by you at any time for as long as the Parties have a trade
relationship with you or where any dues remain unpaid and outstanding with you for the purposes of, (a) opening of the account; (b) debt
recovery; (c) credit/account review; (d) legal documentation consequent to a contract or facility granted by you; (e) credit/account
monitoring and (f) credit/account evaluation. You and/or your appointed debts collecting agency(ies) may disclose any information on the
Parties conduct of their accounts with you to any business entity(ies) for bona fide trade checking at any time. The Parties are also aware and
understand that such information will be provided to your credit reporting agency(ies) and/or debts collecting agency(ies), who may, in turn,
share such information to subscribers of their Service. Where you require any processing of our application to be processed by any processing
centre located outside Malaysia (including your Head Office), the Parties hereby give consent to your appointed registered credit reporting
agency(ies) and/or debts collecting agency(ies) to disclose their credit reports to such locations outside Malaysia. Apart from that, the Parties
undersigned give my/our consent to you and your appointed registered credit reporting agency(ies) and/or your debts collecting agency(ies),
to process my/our personal data as per the Personal Data Protection Act.

Service
I understand I am provisioned with high-speed internet access from my home, either with or without a voice service, based on the plan that I
have subscribed to in the registration form. I am aware that the package detail is available on https://portal.freshtel.my/plan-package-
adviser; Freshtel Internet may change the plans periodically, but such change does not change the Service I have subscribed. The Service is a
personal fixed high-speed internet access that enables me to access the world wide web and any offerings or services available thereon, but I
will be responsible for the risk whenever I am accessing these services. Freshtel Internet Sdn Bhd will provide me with a Service comprising
standard service components: an Optical Network Unit ("ONU") and a Wi-FI router. I understand Freshtel Internet Sdn Bhd aims to provide a
continuous, high-quality service using reasonable care and skill on a best efforts basis. However, I understand Freshtel Internet Sdn Bhd can't
guarantee that it'll be available all the time due to the nature of the Service and the Service Equipment Freshtel Internet Sdn Bhd uses to
provide the Services.

8 MAC 2024
_
CUSTOMER SIGNATURE DATE OF APPLICATION

2 | Page FRESHTEL INTERNET SDN BHD (1154469-D) FT/FORM/FHB21112024

¡˙•Lot 11, 2nd Flooí, Milleíz Squaíe @ Old Klang Road, No. 357, Jalan Kelang Lama, 57000 Kuala Lumpuí.
Website : https://www.fíeshtel.my | !\03-9078 2963 | □ □VVhello@fíeshtel.my V□□ V
 For FRESHTEL INTERNET INTERNAL USE

Assigned Account

Code Remarks:

Verification

Verified by: Verified Date: Completed

SECTION G: REFERRAL INFORMATION

Referral Name : Contact No:

ID Number / Acc. Code:

Referral Signature : Date :

Notes:
- One (1) Application is entitled to one (1) referral only
- Referral must have an existing account

FOR FRESHTEL USE ONLY

CUSTOMER SUPPORT TECHNICAL SUPPORT BILLING SUPPORT

Received Date: Installation Date: Billing Start Date:

Install By: Discount / Waiver:

Remarks: Remarks: Remarks:

3 | Page FRESHTEL INTERNET SDN BHD (1154469-D) FT/FORM/FHB21112024

˙¡•Lot 11, 2nd Flooí, Milleíz Squaíe @ Old Klang Road, No. 357, Jalan Kelang Lama, 57000 Kuala Lumpuí.
Website : https://www.fíeshtel.my | !\03-9078 2963 | □□V Vhello@fíeshtel.my V□□ V