Change of Ownership Form

Change of Ownership Form
Return this form by:
Post Level 26, 44 Market St, Sydney, NSW 2000
Email
Enquiries 1300 160 163
Allow two to three working days to process this form.
A Existing Service Owner
B New Service Owner
Name
Name
Wondercom
Username
Service Number
Business Name
Address
Address
Suburb/Town
Suburb/Town
State
State
Post Code
Phone
(
)
(
)
Phone
(
)
Fax
Fax
(
)
Email
/
Date of Birth
/
Signature
C New Service Owner Payment Details
NOTE: Customers who provide Wondercom with an American Express / Diners Club
card for payment will incur a surcharge of 3.2% (incl. GST) of the invoice amount
when Wondercom debits the card.
Debit my Credit Card
Mastercard
/
Signature
D FTTB Location Change
D
If you require to relocate your FTTB service to a new telephone
number or premises, please request the change by emailing
FTTB service is subject to availability at selected buildings.
Card Type :
Amex
Diners Club
Card Number
Name on Card
Expiry Date
/
Date of Birth
Email
Visa
Post Code
Verification Code
NOTE: For security purposes you are required to provide the Verification Code. The 3
digit number is located on the signature panel on the back of your Visa, Mastercard,
Diners Club.
On American Express, the 4 digit number is located at the front of the card above the
credit card number. Please write this number in the space provided.
E Agreement
I declare that in signing this document I am now responsible for
the above mentioned account. I understand that I am liable for
any current debit balance. Furthermore I have read, understood
and agree to abide by Wondercom’s Terms and Conditions as
stated overleaf, and verify that I am over 18 years of age and am
able to enter into a legally binding contract.
SIGNATURE
NAME
/
DATE
Day
/
Month
Year
SIGNATURE
Direct Debit my Account - Please fill in the Direct Debit form on
the following page.
If paying by Direct Debit please provide driver licence , proof of
age card number for age verification.
Date of issue: 09/06/15 Replace 26/05/15
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Direct Debit Authorisation
This agreement is with Wondercom Pty Ltd (ABN 65 605 332 492). The
direct debit service agreement is issued by Wondercom Pty Ltd
(user ID 486422).
The Service Agreement and the DD Authorisation contain the terms and
conditions on which you authorise Wondercom to debit money from
your account and the obligations of Wondercom and you under this
agreement. You should read through the Service Agreement carefully to
ensure you understand these terms and conditions before signing the
DD Authorisation.
Return this form by:
Post Level 26, 44 Market St, Sydney, NSW 2000
Email
Enquiries 1300 160 163
Allow two to three working days to process this form.
B FTTB Location Number
Please supply the phone number of the phone line you want
FTTB to be installed on.
Phone No.
A Direct Debit Service Agreement
1. Our commitment to you
• Where you have a service with Wondercom that does not include account
usage charges, we will not change the amount or frequency of drawing
arrangements without your prior approval.
• Where you have a service with Wondercom that does include account
usage charges, the amount and frequency of the drawing arrangements
will be as per the terms and conditions of your service agreement with
us. This may require drawing at various times in the month to cover the
usage charges you have incurred.
• Wondercom will not disclose your details except where necessary to
Wondercom’s financial institution and for the purposes of conducting
direct debits with your financial institution.
• Wondercom will give you at least 14 days notice in writing if there are
changes to the terms of the drawing arrangements.
• For monthly recurring subscription charges, Wondercom will draw from
your nominated financial institution account normally 7 days prior to the
expiry of your current account’s subscription period. If the due drawing
date is not a business day, Wondercom will draw on the business day
before or after that date.
Username
D Contact Details
First Name
Surname
Address
Suburb
State
Phone
• Ensure there are sufficient funds available in the nominated account to
meet each drawing.
Mobile
Number
• Advise us if the nominated account is transferred or closed, or the
account details change.
Email
• Ensure that all account holders on the nominated financial institution
account sign the Direct Debit Authorisation.
A fee of $10 applies if the financial institution rejects a Direct Debit
transaction.
Available payment methods are by bank account direct debit or by
credit card. If you wish to change your payment method, please contact
Wondercom customer service.
3. Your rights
If you wish to alter the drawing arrangements for your next direct debit and
your service does not include usage charges, please contact Wondercom
at least 7 days prior to the due date of your service package renewal.
Otherwise if your service does include usage charges, please contact
Wondercom immediately to allow this change to be processed as soon as
possible. Wondercom cannot guarantee that changes can be made in time
for the next direct debit but will strive to achieve this wherever possible.
The drawing arrangements may include:
1.stopping an individual drawing
2.altering the DD Authorisation
)
C Your Username
Once you have registered for Wondercom FTTB, we will send you
your username via email, which you should then enter here.
2. Your commitment to us
It is your responsibility to:
• Ensure your nominated account can accept direct debits.
• Arrange an alternative payment method acceptable to Wondercom if
Wondercom cancels the drawing arrangements.
(
Post
Code
(
)
E Direct Debit Payment Details
Please provide details of the account you wish to debit.
I/We request Wondercom Pty Ltd (ABN 65 605 332 492) to draw
money from my/our account conducted with:
-
BSB
Number
Account
Number
Name of
Financial
Institution
Branch
Accountholder’s
Name(s)
Signature
3.canceling the DD Authorisation
Where you consider that a drawing has been initiated incorrectly, you
should first contact Wondercom Customer Service. If you are not satisfied
with the response, please write to us. Your letter should be marked “Notice
of Complaint” and addressed to: Wondercom Level 26, 44 Market St,
Sydney, NSW 2000.
F Agreement and Authorisation
Wondercom will respond within 7 days of receiving your letter. Wondercom
has formal procedures for dealing with a complaint.
Date of
Birth
You may also direct any disputes, stops or cancellations through your
financial institution.
Signature
4. Other information
You should be aware that there are risks involved with providing
instructions and personal information over the internet.
Full Name
Wondercom reserves the right to cancel drawing arrangements if drawings
are dishonoured by your financial institution. Your drawing arrangements
are also governed by the terms and conditions of your Wondercom account.
I/We declare that I/We have read, understood and agree to abide by the
terms of the Direct Debit Service Agreement and Terms and Conditions
of my/our Wondercom account, and verify that I/We are over 18 years of
age and able to enter into legally binding contracts.
/
/
/
/
Title
Date
Date of issue: 09/06/15 Replace 26/05/15
Page 2 of of 3
Customer Service Guarantee Waiver
Return this form by:
Post Level 26, 44 Market St, Sydney, NSW 2000
Email
Enquiries 1300 160 163
Allow two to three working days to process this form.
Customer Service Guarantee Waiver
You wish to continue to acquire a Wondercom Voice plan in respect of which Wondercom Pty Ltd (Wondercom) proposes that you waive the
rights and protections under the Telecommunications (Customer Service Guarantee) Standard (the “CSG”). If you do not wish to waive those
rights, please select a Wondercom Voice plan which does not require a waiver of the CSG.
The CSG is a guarantee that is prescribed under the Telecommunications Act 1997 and gives consumers certain rights in connection with standard telephone services. These rights include:
a. The right to be provided with information about the CSG and the performance standards applicable under it;
b. The right to receive compensation if a standard telephone service is not connected within a specified timeframe;
c. The right to receive compensation if a fault or service difficulty exists on a standard telephone service and is not rectified within a specified timeframe;
d. The right to receive compensation if Wondercom misses an appointment with a customer with whom Wondercom has made an appointment
in connection with the standard telephone service.
The specified timeframes and the amounts of compensation vary based on the customer location, the nature of the infrastructure available at
the customer site and the length of time during which default has occurred. As an example of the range of compensation, compensation for an
unrepaired fault ranges from $14.52 to $48.40 per day and compensation for a missed appointment ranges from $14.52 to $24.20. Full detail of
the compensation can be found with a search of the ACMA website (www.acma.gov.au).
Wondercom Voice plans where the CSG is waived are low priced. Wondercom believes that there is therefore a significant benefit available to
you if you waive the CSG.
You are under no obligation to consent to the waiver. You should make your own assessment as to whether the non-CSG plans represent sufficient value for you to waive the rights given to you under the CSG.
By agreeing to this document you are waiving your rights and protections under the CSG and are not able to make a claim against Wondercom
for compensation under the CSG in connection with the Wondercom Voice service that you have acquired.
Your acceptance of this proposed waiver of your rights & protections under the CSG will take effect on the date you agreed to this waiver (either
by submitting the form online by clicking “Next” or by agreeing orally if you applied on the phone) unless, within 7 days, you withdraw your
waiver and communicate that withdrawal to Wondercom. If you do withdraw your waiver, Wondercom will not be able to supply the Wondercom Voice service to you.
For more information, please contact Wondercom Sales on 1300 160 163.
Waiver
I, _________________________________________ (insert your name) understand the protections & rights under the Customer Service
Guarantee and agree to waive wholly those protections & rights as they apply to the Home Phone service supplied to me by Wondercom at
_________________________________________________________________________(insert your address)
_____________________________ (Signature)
_____________________________ (Date)
Date of issue: 09/06/15 Replace 26/05/15
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