Application-Cum-Agreement For Pacnet Service

BROADBAND ACCESS - RELOCATION / MODEM PROFILE CHANGE

Page 1 of 3 pages

Account Holder's Particulars
Name:
NRIC:
Current Broadband number:
Account number:
User ID:

I wish to relocate my current broadband phone number and installation address. I am aware that there will be a relocation fee of $74.90 charged to my Pacnet account. My billing address will also be updated to the new Installation address unless otherwise specified.
I wish to change my broadband modem profile. I am aware that there will be an admin fee of $16.05 charged to my Pacnet account.

All prices are inclusive of prevailing GST.