Change of Ownership Form

Change of Ownership Form
Return this form by: Fax 02 9850 0813
In person 65 Waterloo Road, North Ryde, NSW 2113
Post PO Box 1844, Macquarie Centre, North Ryde NSW 2113
Email [email protected] Enquiries 13 14 23
Register Online www.tpg.com.au
Allow two to three working days to process this form.
A Existing Service Owner
B New Service Owner
Name
Name
TPG Username
Service Number
Business Name
Address
Address
Suburb/Town
Suburb/Town
State
State
Post Code
Phone
(
)
(
)
Phone
(
)
Fax
Fax
(
)
Email
/
Date of Birth
/
Signature
/
Signature
D DSL location Change
D
C New Service Owner Payment Details
NOTE: Customers who provide TPG with an American Express or Diners Club cards
incur a surcharge of 3.13% and 2.75% (incl. GST) of the payment amount respectively
when TPG debits the card.
Debit my Credit Card
Mastercard
If you require to relocate ADSL service to a new telephone number
or premises, please request the change through our homepage:
http://cyberstore.tpg.com.au/your_account
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 TPG’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: 30/08/16. Replaces: 27/07/16 Page 1 of 3
Direct Debit Authorisation
TPG Internet Pty Ltd and Soul Communications Pty Ltd are fully owned
subsidiaries of TPG Telecom Limited. This agreement is with TPG Internet Pty
Ltd (ABN 15 068 383 737) and Soul Communications Pty Ltd (ABN 99 085
089 970). The direct debit service agreement is issued by TPG Internet Pty
Ltd (user ID 142619).
Return this form by: Fax 02 9850 0813
Post PO Box 1844, Macquarie Centre, North Ryde NSW 2113
Email [email protected]
Enquiries 13 14 23
Register Online www.tpg.com.au
The Service Agreement and the DD Authorisation contain the terms and
conditions on which you authorise TPG Internet to debit money from B
ADSL Location Number
your account and the obligations of TPG Internet and you under this
Please supply the phone number of the phone line you want
agreement. You should read through the Service Agreement carefully to
ensure you understand these terms and conditions before signing the
ADSL to be installed on.
DD Authorisation.
Phone No.
A Direct Debit Service Agreement
(
1. Our commitment to you
We will not change the amount or frequency of drawing arrangements
without your prior approval.
C Your Username
Once you have registered for TPG Broadband or TPG Mobile, we will
send you your username via email, which you should then enter here.
TPG Internet will not disclose your details except where necessary to TPG
Internet’s financial institution and for the purposes of conducting direct
debits with your financial institution.
Username
TPG Internet will give you at least 14 days notice in writing if there are
changes to the terms of the drawing arrangements.
D Contact Details
TPG Internet will draw from your nominated financial institution
account on the business day normally 7 days prior to the expiry of your
current account’s subscription period. If the due drawing date is not a
business day, TPG Internet will draw on the business day before or after
that date.
2. Your commitment to us
It is your responsibility to:
• Ensure your nominated account can accept direct debits.
• Ensure there are sufficient funds available in the nominated account
to meet each drawing on the due date.
• Advise us if the nominated account is transferred or closed, or the
account details change.
• Arrange an alternative payment method acceptable to TPG Internet if
TPG Internet cancels the drawing arrangements.
• 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
TPG customer service.
3. Your rights
You should contact TPG Internet if you wish to alter the drawing
arrangements. This includes:
• stopping an individual drawing
• altering the DD Authorisation
• cancelling the DD Authorisation
First Name
Surname
Address
Suburb
State
Phone
Post
Code
(
)
Mobile
Number
Email
E Direct Debit Payment Details
Please provide details of the account you wish to debit.
I/We request TPG Internet Pty Ltd (ABN 15 068 383 737) to draw
money from my/our account conducted with:
-
BSB
Number
Where you consider that a drawing has been initiated incorrectly, you
should firstly contact TPG Customer Service on the number appearing
above. If you are not satisfied with the response, please write to us. Your
letter should be marked “Notice of Complaint” and addressed to: TPG
Internet at the address appearing above.
Account
Number
TPG Internet will respond within 7 days of receiving your letter. TPG
Internet has formal procedures for dealing with a complaint.
Branch
You may also direct any disputes, stops or cancellations through your
financial institution.
Accountholder’s
Name(s)
4. Other information
)
Name of
Financial
Institution
You should be aware that there are risks involved with providing
instructions and personal information over the internet.
Signature
TPG Internet reserves the right to cancel drawing arrangements if
drawings are dishonoured by your financial institution.
F Agreement and Authorisation
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 TPG account, and verify that I/We are over 18 years of age and
able to enter into legally binding contracts.
Your drawing arrangements are also governed by the terms and
conditions of your TPG account.
Date of
Birth
/
/
/
/
Signature
Full Name
Title
Date
Date of issue: 30/08/16. Replaces: 27/07/16 Page 2 of 3
Customer Service Guarantee Waiver
Return this form by: Fax 02 9850 0813
Post PO Box 1844, Macquarie Centre, North Ryde NSW 2113
Email [email protected]
Enquiries 13 14 23
Register Online www.tpg.com.au
Customer Service Guarantee Waiver - Applies to ADSL2+ with Home Phone Bundle and NBN Bundles
You wish to continue to acquire a TPG Voice plan in respect of which TPG Internet Pty Ltd (TPG) requires you to waive certain rights and protections provided under the Telecommunications (Customer Service Guarantee) Standard 2000 (No.2) (the “CSG”).
The Customer Service Guarantee (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 TPG misses an appointment with a customer with whom TPG 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).
TPG Voice plans where the CSG is waived are lower priced than TPG Voice plans where the CSG is not waived. TPG believes that there is therefore
a significant benefit available to you if you waive the CSG.
The consequences of agreeing to waive these rights are that you are not entitled to receive this compensation.
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 TPG for
compensation under the CSG in connection with the TPG 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 (by
submitting the form) unless, within 5 working days, you withdraw your waiver and communicate that withdrawal to TPG. If you do withdraw
your waiver, TPG will not be able to supply the TPG Voice service to you.
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 ADSL2+ with Home Phone Bundles or NBN Bundles
supplied to me by TPG at _________________________________________________________________________(insert your address)
_____________________________ (Signature)
_____________________________ (Date)
Date of issue: 30/08/16. Replaces: 27/07/16 Page 3 of 3