APPLICATION FOR SERVICE MODIFICATION

PART A : CUSTOMER DETAILS

TTdC/CSVS/FRM/009/Rev 4

Name : (Individual Name as per I/C/Passport

Contact Person : ______________________________________________

Account Number :
Service Number :
Service Number(s) to be modified :

Date of modification

1)

(please use separate sheet if space is

required:

insufficient)

2)

Total line(s) :

3)

(dd)

PART B : MODIFICATION SERVICE (PLEASE TICK

(mm)

(yy)

WHERE APPLICABLE)

Indoor Relocation

ISDN PRI / PABX Line Reconfiguration

Change of CRD

Discount Plan

Remove DDoS Shield from existing ID

Outdoor Relocation

Modify Service Features

Customer Profile Change

Pilot Hunting

Add DDoS Shield to existing ID

Request number to be listed

Change of Service Number

Change of Bill Cycle

Direct Line

Customer's IP prefix: _____________

Basic Voice Line Reconfiguration

Merge Account

Upgrade BroadBand Service

Call Forwarding/Divert Call

Mitigation Tunnel Destination IP: _____

Basic Voice Line Plus Reconfiguration

Segregate Account

Downgrade BroadBand Service

Call Waiting

Activate Value-Added Service

Transfer Ownership

Contract Renewal / Price Revision

To Bar IDD & STD Calls

Reminder Calls

Barring Control

Virtual Call-Remove AutoDialer

To Bar 600 Calls

To Allow All Outgoing Calls

Three Way Calling

To bar IDD, STD and 600 calls

Account Managed

To Allow Local & 800 Calls

To Bar All Outgoing Calls

To bar IDD calls

Non-Account Managed

To Bar IDD, Mobile & 600 Calls

To Bar IDD & 600 Calls

Price Protection: Early Bandwidth entitlement (1 month earlier before entitlement date)

Deactivate Value-Added Service

Change Account Management Status :

Change of Billing Address

Please specify : (New) ________________________________________________________________________________________

Replace Existing Directory Number

Please specify : (Old) ___________________________

If e-Paper, pls specify e-mail address:

(New) ___________________________

Purchase of new Bandwidth-on-Demand Blocks

Please specify start date: (dd/mm/yy) ___________________________

Please specify end date: (dd/mm/yy) ___________________________

Cancel Bandwidth-on-Demand Schedule

Please specify start date: (dd/mm/yy) ___________________________

Please specify end date: (dd/mm/yy) ___________________________

Add TIME Dynamail (Unified Email, Shared address book, calendar, task, shared files, 400GB Domain Hosting + SSL)
TIME Dynamail Storage Upgrade Please specify:_________GB (RM500/100GB/month)
Additional description/information
of modification (if any) :

PART C : MODIFICATION CHARGES

Change of Service Number

Relocation Charge

Basic Voice Line

RM 10 / line

RM 30 / line

On-Site Configuration

RM100/line

RM30/line

1800 / 1300 Toll Free

RM 50 / line

N/A

ISDN PRI / PABX Link

*RM 100 / link

RM 1000 / link (Indoor & Outdoor)

Netlynx Voice

RM 10 / line

RM 30 / line

Channelized Leased Line

N/A

RM 1000 / link (Indoor)

RM 2000 (Outdoor)

*Different charges applies for Inter State Outdoor relocation

Private Leased Line (SDH)

N/A

RM 1000 / link (Indoor)

RM 2000 (Outdoor)

*Different charges applies for Inter State Outdoor relocation

IPLC

N/A

RM 1000 / link (Indoor)

RM 2000 (Outdoor)

*Different charges applies for Inter State Outdoor relocation

Channelized Direct

N/A

RM 1000 / link (Indoor)

RM 2000 (Outdoor)

*Different charges applies for Inter State Outdoor relocation

Internet Direct (SDH)

N/A

RM 1000 / link (Indoor)

RM 2000 (Outdoor)

*Different charges applies for Inter State Outdoor relocation

Ethernet Leased Line / Metro Lan

N/A

RM 5000 / site (Indoor / Outdoor)

Private Leased Line (MLAN / ME)

N/A

RM 5000 / site (Indoor / Outdoor)

IEPL

N/A

RM 5000 / site (Indoor / Outdoor)

Ethernet Direct

N/A

RM 5000 / site (Indoor / Outdoor)

Internet Direct (ME)

N/A

RM 5000 / site (Indoor / Outdoor)

TIME Broadband (Residential)

N/A

RM 80 / line (Indoor)

RM 120 (Outdoor)

TIME Broadband (Business)

N/A

RM 90 / line (Indoor)

RM 129 (Outdoor)

TIME Business Internet Pro

N/A

RM 90 / line (Indoor)

RM 129 (Outdoor)

Broadband Metro

N/A

RM 2,500 / line (Indoor) RM 3,500 (Outdoor)

TIME Satellite

N/A

RM 2,500 / site (same premise) RM4,812.50 (different premise)

The Star ePaper and Flavours eMagazine

N/A

N/A

N/A

Monthly Charge: RM25

IMPORTANT NOTES
1) Rate quoted above are per number / link / site transaction based on respective product.
2) * All PABX Modification for change of service number are charged at RM100.00, irrespective of type/categories .
3) Separate form(s) are to be used for non-similar service/product.

PART D: DECLARATION
1) I/We hereby confirm that I/We have requested the above service modification(s) to be affected as per the stipulated date.
2) I/We hereby agree that I /We will bear any charges incurred (if any) for the modification(s) transaction.

Company Stamp
(for Corporate / Business Customers)
Date : _________/________/__________
Signature

(dd)

Customer)

(yy)

(mm)

Name : __________________________________
I/C Number : ______________________________

FOR TIME OFFICE USE ONLY

Business

Service Modification Authorization

Residential

Authorized by :

Sales Rep./Account Mgr : ________________________________________________________

10

20

Waiver

No

Yes

Activated

Activation Status
Region

Approved

30

Unit Head/Dept.Manager/GM/ HOD

Denied
Not Applicable

Pending Activation
N

*Waiver :

Date : ______/______/______
E

(dd)

EM

(mm)

Amount : RM _________________

(yy)

*Approval for waiver shall be based on DAL

For Contact Centre:

For SOM Use Only

CMS By

Received Date

:_______________________________________

Input In TBS By : _______________________________________

Received By

: _______________________________________

Remarks

: _______________________________________

: _________________________________________________________________

PLEASE FAX THIS FORM TO : 03-5032 6579