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TELSTRA BUSINESS MOBILE PLUS PLANS TRANSFER OF OWNERSHIP FORM

FORM C

1. EXISTING ACCOUNT HOLDER DETAILS Account Name/Account Holder Title Surname Existing Account Number Trading Name (if applicable) Account Holder Address Email Address

3. ADDITIONAL DETAILS FOR INCOMING ACCOUNT HOLDER (a) Other Telstra Services in Account Holder Name Given Name (b) Account Contact (if different from above) Title Surname Phone
( )

Given Name Fax Number


( )

ACN/ABN/ARBN City/Suburb Postcode

Billing Address (if different to Customer Address)

City/Suburb

Postcode

(c) Personal Identification Sole Trade, Partnership and Unincorporated Accounts only Enter details in relevant fields (e.g. do NOT enter credit card number if used) Date of Birth / /
Document Type Points Doc/Acc.No. Date Issued Expiry Date D.O.B. PRIMARY (at least one form) 1 2

2. DETAILS OF ACCOUNT HOLDER TO WHOM SERVICES WILL BE TRANSFERRED TO BE COMPLETED BY INCOMING ACCOUNT HOLDER Important Do not sign this application unless you have received and read the Business Mobile Services What you need to know when signing up Booklet and Telstras Protecting Your Privacy statement. Account Name/Account Holder Title Surname Given Name Trading Name (if applicable) Account Holder Address Email Address ACN/ABN/ARBN City/Suburb Postcode

SECONDARY 1 (at least 2 one form) 3 TOTAL POINTS (must be 100 minimum)

4. USER DETAILS (if different from Account Holder details in 2) Title Surname Given Name 5. COMPANIES, INCORPORATED ASSOCIATIONS AND GOVERNMENT DEPARTMENTS Verified ID of Company Representative (e.g. Employee Card, Corporate Credit Card) Title Surname Given Name Type of ID Expiry Date
/ /

Previous Address (if less than 12 months at current) City/Suburb Period at previous address
Years Months

Postcode

Phone
( )

Fax Number
( )

Letter of Authorisation OR Purchase Order No. Directors, Committee Members or Authorised Government Representatives (if different from Account Holder Details) Surname Given Name Phone Number
( ( ) )
THIS FORM REMAINS THE PROPERTY OF TELSTRA

Years of Incorporation (Companies only)

Industry Type (if applicable)

C178 11-10

Registered trade mark of Telstra Corporation Limited A.B.N. 33 051 775 556 Trade mark of Telstra Corporation Limited

6. DETAILS OF SERVICE TO BE TRANSFERRED


Casual ($35 only) Member Plan (12 month) Member Plan (24 month) Phone Plan (24 month) Net Ready MMEP

Mobile Service Number*

$10 $25 $35 $45 $65 $85 $100 $120 $130 $150

A B C D E

0:4: 0:4: 0:4: 0:4: 0:4:

: : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : :

9. EXISTING ACCOUNT HOLDER OWNER ACCEPTANCE FOR TRANSFER OF OWNERSHIP ONLY By signing this section, I agree that: i) at the time Telstra accepts this application, Telstra will transfer the service(s) listed in Section 6 to the Account named in Section 2 on the terms set out on this application form; ii) I will be liable for all fees and charges incurred in relation to these services at the time that Telstra accepts this application; iii) any requests for variation, suspension or cancellation of the service(s) after this date may only be made by the New Account Holder; iv) Telstras commitment to privacy is set out in Telstras Protecting Your Privacy statement I have received from Telstra; v) Telstra may obtain information about me, including a consumer credit report from a credit reporting agency, and may use and disclose personal and credit information about me as set out under Privacy considerations on the back of this form. I warrant that all information in Sections 1 and 6 is true and correct. If I am the Authorised Signatory, but am not the Existing Mobile Service Owner, I warrant that I am authorised to sign this form on the Existing Mobile Service Owners behalf. Existing Service Owner Name Date
/ /

EOM

7. VALUE ADDED SERVICES DETAILS (IF APPLICABLE) Choose your additional Monthly Data pack: Amount $_________________ (incl. GST) Service Level Pack (not available on $10, $130 or $150 Plans): Untimed Voice (not available on $25 or $100 Plans) $10 Free MessageBank Diversion and Retrieval $5 SMS and MMS Pack $10 SMS and MMS Pack Choose your messaging option ($150 Plan customers only): Free MessageBank Diversion and Retrieval Free MessageBank Diversion and Retrieval and free Voice2Text messages 8. DEALER AGENT AUTHORISATION I am satisfied that the details provided on this form apply to the Account Holder and that the Account Holder/Authorised Signatory has shown me 100 points of current identification (in original form) to meet Telstras ID requirements. I confirm that I have provided a copy of the Business Mobile Services What you need to know when signing up Booklet, written program and service details and Telstras Protecting Your Privacy statement to the Authorised Signatory or to the Account Holder. I nominate the equipment described above for participation in the promotional package. I confirm that I have explained to the Account Holder that they may incur an early termination charge if this application involves an upgrade or a recontract of their existing Telstra mobile service that is still within a minimum term. NAC Operator Dealer Name of Dealer/Agent Representative (please print) Signature of Dealer/Agent Representative Date
/ /
C178 11-10

BES

BIS

Existing Service Owner/Authorised Signatory 10. ACCOUNT HOLDER ACCEPTANCE IMPORTANT: Please read these terms, the terms on the back of this form, the pricing brochure we give you and our Business What you need to know when signing up Booklet (Booklet). If there is anything you dont understand, please speak to the dealer or us. By signing this form, you are acknowledging that you have read and agree to be bound by the terms in this form, as well as Our Customer Terms. You agree: Under Our Customer Terms, we can change the terms and prices of your plan. The summary of Our Customer Terms sets out how we can do this. If you use your Telstra service overseas, you will be charged for international roaming. If you use mobile data services overseas, it wont come out of your included data, and unless you take up a separate plan, you will be charged $15 per MB. We have explained to you that you will be charged for calls you make or for data you use in excess of, or which is not eligible to draw from, the included calls or data on your plan. The terms and conditions set out the types of calls which are not eligible. We have tools you can use to monitor your data usage and we recommend you sign up for these. You have received the Booklet which includes a copy of Telstras Privacy Statement Protecting Your Privacy. All information you have provided in this application is correct and that if you are not the Account Holder, you are authorised to sign this form on behalf of the Account Holder. You may be able to use your Telstra mobile services to purchase goods, services or content from a third party. If you do so, Telstra will debit the charges for the content, goods or services from your account. If you dont pay Telstra when due, Telstra may cancel your service. Account Holder Full Name (please print) Account Holder/Authorised Signatory Telstra Mobile phones may interfere with sensitive biomedical electronic devices check with your specialist before use.
THIS FORM REMAINS THE PROPERTY OF TELSTRA

Authorisation No. Premise Code


: : :

Date
/ /

Registered trade mark of Telstra Corporation Limited A.B.N. 33 051 775 556 Trade mark of Telstra Corporation Limited

TELSTRA BUSINESS MOBILE PLUS PL ANS TERMS AND CONDITIONS


General Conditions for Telstra Business Mobile PLUS Plans 1. ELIGIBILITY To be eligible for a Telstra Business Mobile PLUS Plan (PLUS Plan), you must: (a) have a 10 digit account number; (b) have an ABN, ACN or ARBN; and (c) not have a Telstra Corporate Plan, Telstra Business Mobile Cap Plan, Telstra Business Smartphone Plan or Telstra Ultimate Plan on the same account as your PLUS Plan. 2. PLAN DETAILS PLUS Plans are available as: (a) Member Plans, for a minimum term of 12 or 24 months. You can buy an eligible handset under Telstras Mobile Repayment Option (MRO), bring your own handset or buy a new handset outright; or (b) Phone Plans, for a minimum term of 24 months which include a subsidised handset; or (c) Casual Plans, which do not have a minimum term If you want to connect your existing eligible Telstra mobile service to a PLUS Plan, you will need to cancel your current plan and pay us any applicable early termination and administration charges. 3. PRICING The prices for your PLUS Plan services depend on the number of eligible services you have on your account at any one time. A summary of the pricing is set out in the Pricing Brochure we will give you. Full details are in Our Customer Terms. 4. INCLUDED CALLS AND BENEFITS (a) PLUS Plan 100 The PLUS Plan with a $100 Monthly Fee (PLUS Plan 100) includes: i) unlimited standard calls in Australia; ii) unlimited diversion of calls from mobile numbers in Australia to most other fixed and mobile numbers in Australia; and iii) unlimited calls to 1800 numbers in Australia. Messages (SMS and MMS) and MessageBank diversion and retrieval in Australia are not included in the PLUS Plan 100 and you need to pay for these separately. (b) PLUS Plan 130 The PLUS Plan with a $130 Monthly Fee (PLUS Plan 130) includes: i) unlimited standard calls and messages in Australia; ii) unlimited calls to 1800 numbers in Australia; iii) unlimited diversion of calls from mobile numbers in Australia to most other fixed and mobile numbers in Australia; iv) free MessageBank diversion and retrieval in Australia; and v) an allowance of $50 each month for calls and messages to international numbers.
C178 11-10

(c) PLUS Plan 150 The PLUS Plan with a $150 Monthly Fee (PLUS Plan 150) includes: i) unlimited standard calls and messages in Australia; ii) unlimited calls to 1800 numbers in Australia; iii) unlimited diversion of calls from mobile numbers in Australia to most other fixed and mobile numbers in Australia; iv) a choice of free MessageBank diversion and retrieval in Australia, or free MessageBank diversion and retrieval in Australia and unlimited Voice2Text messages in Australia; v) an allowance of $100 each month for calls and messages to international numbers; and vi) an allowance of $50 each month for international roaming (d) All other PLUS Plans The PLUS Plan with a $10 Monthly Fee has no included calls and messages. The PLUS Plan with a $25 Monthly Fee has $15 of included standard calls and messages. All other PLUS plans have included standard calls and messages equal to the value of the Monthly Fee. (e) Standard calls and messages Unless your PLUS Plan provides otherwise, standard calls and messages means most types of national direct dial voice calls and data calls (including WAP circuit or packet switched data calls and internet usage, voice calls to a 13 number (including 1300 or 1345 number), Directory Assistance calls, video calls, SMS and MMS. Standard calls and messages does not include calls to the Sensis 1234 service, calls to 12234 and 12455, third party content calls, international calls, international roaming calls, international SMS and MMS and calls to 19xx, 1800 and 12xx numbers. (f) Call Diversion Unlimited call diversion includes diversion of calls to fixed numbers in Australia with an 02, 03, 07 or 08 area code and mobile numbers in Australia commencing with 04xx (g) FairPlay Policy and expiry of unused allowance Our FairPlay policy applies to any unlimited included allowance. Any unused included allowance expires monthly. 5. SHARE INCLUDED CALLS You may share your included standard calls and messages with other services connected on your PLUS account (except the unlimited included standard calls on the PLUS Plan 100, and included standard calls and messages on the PLUS Plans 130 and 150, which cannot be shared with other services). If you have Telstra Business Cap Plans, Telstra Next G 3G Cap Plans, Next G Cap Plans, Business Smart Phone Plans, Member and Phone Plan Ultimate, Telstra Capped Plus Plans, Telstra Business Talk Plans,

Telstra Business Talk Saver Plans, Telstra Business Untimed Plans or Telstra BusinessMobile Select Plans (Incompatible Plans) on your account, no services (including PLUS Plan services) can share included calls or messages. 6. FREE INTRA ACCOUNT CALLS IN AUSTRALIA You can make free national voice calls to other eligible Telstra mobile services on the same account. You will not be charged a call connection fee. FairPlay Policy applies. 7. END OF CONTRACT At the end of your contract term you will remain on your chosen PLUS Plan on a month-to-month basis, but your loyalty bonus will stop. If your chosen PLUS Plan is no longer available, we may move your service to a reasonably comparable alternative service, or you may cancel your service. 8. GENERAL TERMS Your Telstra mobile service includes a number of features including voice, SMS, MMS, MessageBank and Video MessageBank and Video Calling (service features). Special terms and prices apply to these as set out in Our Customer Terms. Telstras Our Customer Terms apply to all Telstra services relevant to your PLUS Plan. We may vary Our Customer Terms (as set out in the Booklet). 9. PRIVACY Our Protecting Your Privacy statement describes how we and our related companies will collect, use and disclose your personal information (including for marketing to you) and your rights in relation to accessing and correcting that information. You also agree that we may, subject to the Privacy Act 1988 (Cth): (a) disclose information about you and this application, (including information contained in any application for additional services and information relating to the conduct of your account) to a credit reporting agency for the purpose of obtaining and maintaining a credit information file about you, and to another credit provider or a collection agent for the purpose of collecting overdue payments relating to credit owed by you and notifying defaults by you; and (b) obtain and use information about your creditworthiness (including a consumer or commercial credit report) from a credit reporting agency, credit provider or other business that reports on creditworthiness for the purpose of assessing an application (including this application and any application for additional services) or collecting overdue payments. In this section 7,you and your refers to you and your Authorised Signatory (if applicable).

Registered trade mark of Telstra Corporation Limited A.B.N. 33 051 775 556 Trade mark of Telstra Corporation Limited

TELSTRA BUSINESS MOBILE PLUS PL ANS TERMS AND CONDITIONS


10. GOODS AND SERVICES TAX & STAMP DUTY Where Telstra makes a taxable supply to you and the consideration for the supply is not expressed to be inclusive of GST, you must pay, an additional amount where you pay or provide GST exclusive consideration, equal to the value of that exclusive consideration (without deduction or set-off) multiplied by the prevailing GST rate. Telstra will issue a tax invoice to you for any taxable supply. You agree to pay us any stamp duty which is payable in relation to this application, up to a maximum of $20. Telstra Business Mobile PLUS Member Plans and Phone Plans Special Conditions 11. EMAIL READY PACKS AND NET READY PACKS If your service is connected to a BlackBerry handset, you can choose a Net Ready Pack, a BlackBerry BIS Email Ready Pack (BIS Pack) or a BlackBerry BES Email Ready Pack (BES Pack). If your service is connected to an ActiveSync compatible handset you can choose a Net Ready Pack, a MMEP Email Ready Pack (MMEP Pack) or an Exchange Online Mobile Pack (EOM Pack). To choose an EOM Pack you also have to subscribe to Exchange Online or Business Productivity Suite via T-Suite. Net Ready Packs include an amount of included data. Email Ready Packs include an email allowance and an amount of included data. Unused included data expires at the end of each month. Eligible data usage for the included data is described in Our Customer Terms. You cannot share included data or email with any other services. Net Ready Packs and Email Ready Packs are not available on PLUS Plans with a $10 Monthly Fee. 12. PAYMENT Each month you have to pay: (a) your Monthly Fee; (b) any charges for calls or messages in excess of or not eligible to draw from your included standard calls or messages; plus (c) any charges for data usage in excess of or not eligible to draw from your included data; plus (d) an Email Ready Pack fee if you have selected: (i) an EOM Pack or MMEP Pack and your Monthly Fee is less than $85; (ii) a BIS Pack and your Monthly Fee is less than $65; (iii) a BES Pack and your Monthly Fee is less than $150. We also charge you for other services you use which are not included in your PLUS Plan. 13. BONUS OPTION If you have a Member Plan or Phone Plan with a Monthly Fee of $25 or more you must choose a Bonus Option. You are not eligible for any Bonus Options if your Monthly Fee is $10, $100, $130 or $150.
C178 11-10

The Bonus Options are Business Hours, Any Mobile, Untimed to Landlines, and Free MessageBank Diversion and Retrieval and No Call Connection Fee. If you change your Bonus Option more than once during any 30 day period we can charge you a $15 administration fee per change. Our FairPlay Policy applies. 14. SERVICE LEVEL PACKS For an additional monthly charge, you may choose one or more of the Service Level Packs, except if your Monthly Fee is $10, $130 or $150. Customers with a Monthly Fee of $25 or $100 are not eligible to choose the Untimed Voice Service Level Pack. The Service Level Packs are Untimed Voice, Free MessageBank Diversion and Retrieval and SMS and MMS. If you choose the Untimed Voice Service Level Pack, you will not be eligible to choose any Bonus Options. Depending on the Service Level Pack you choose, you may not be eligible for certain Bonus Options. 15. PHONE PLAN: SUBSIDISED HANDSET You can buy a handset from us at a subsidised price when you connect to a Phone Plan. If you select this option, you will not be eligible for a Loyalty Bonus Credit. 16. MEMBER PLAN: LOYALTY BONUS CREDIT If you choose a 24 month Member Plan with a Monthly Fee of $25 or more you will receive a Loyalty Bonus Credit. The Loyalty Bonus Credit cannot be shared with other services and is not redeemable for cash. 17. PORT IN CREDIT If you port an existing mobile phone number from another mobile service provider and connect it to a 24 month Telstra Business Mobile PLUS Member Plan or Phone Plan with a Monthly Fee of $35 or more, you will be eligible for a Port In Credit. You may be required to reimburse us for your Port In Credit if the service is cancelled before expiry of the minimum term on a pro-rata basis. 18. CHANGING YOUR PLAN You may move to another PLUS Plan, another Telstra offer or cancel your PLUS Plan during your minimum contract term. The terms applying to these changes are set out in Our Customer Terms. In certain circumstances, we may require you to (i) restart your minimum contract term, (ii) pay the applicable early termination charge and/or (iii) pay a $50 administration fee. 19. EARLY TERMINATION CHARGE If you cancel (other than as a result of our material breach) or we cancel your Member Plan or Phone Plan during your minimum contract term, we may charge you an early termination charge* (ETC) calculated as follows:

ETC payable = Base ETC (see table below) x number of months remaining in your minimum term Total number of months in your minimum term * Plus the balance of any MRO amount outstanding if applicable. The ETC payable is set out in the table below.
Monthly Fee $10 $25 $35 $45 $65 $85 $100 $120 $130 $150 Net Ready Pack or Email Ready Pack Not applicable Net Ready Pack Email Ready Pack^ Net Ready Pack Email Ready Pack^ Net Ready Pack Email Ready Pack^ Net Ready Pack Email Ready Pack^ Net Ready Pack Email Ready Pack^ Net Ready Email Ready Net Ready Pack Email Ready Pack^ Net Ready Email Ready Net Ready Pack Email Ready Pack^ Phone Plan# Not applicable $375.36 $619.36 $575.39 $819.39 $784.45 $1,028.45 $1,045.07 $1,289.07 $1,280.41 $1,475.61 $2,400 $2,400 $1,722.88 $1,820.48 $3,120 $3,120 $3,600.00 $3,600.00 Base ETC Member Plan Member Plan 12 month plan 24 month plan $54.90 $109.80 $62.68 $125.36 $184.68 $369.36 $112.70 $225.39 $234.70 $469.39 $194.72 $389.45 $316.72 $633.45 $252.53 $505.07 $374.53 $749.07 $315.20 $630.41 $412.80 $825.61 $1,200 $2,400 $1,200 $2,400 $436.44 $872.88 $485.24 $970.48 $1,560 $3,120 $1,560 $3,120 $1,800.00 $3,600.00 $1,800.00 $3,600.00

 he applicable Base ETC may be less depending on the handset T you choose. ^ The applicable Base ETC may be less depending on the Email Ready Pack you selected. The Base ETC is the maximum ETC you will need to pay. The ETC payable decreases over the life of your minimum contract term. We may also charge you a $50 administration fee in addition to the ETC. Please contact us or your dealer for the amount of the ETC payable. Telstra Business Mobile PLUS Casual Plans Special Conditions 20. PAYMENT You have to pay: (a) a $35 Monthly Fee each month; (b) any charges for calls in excess of or not eligible to draw from your included standard calls and messages. You must also pay us for data usage and for other services you use which are not included in your Casual Plan. 21. CHANGING OR CANCELLING YOUR SERVICE You can cancel your Casual Plan at the end of any month by telling us. If you do so before the end of a billing month, you will be charged your monthly subscription fee on a pro-rata basis.

Registered trade mark of Telstra Corporation Limited A.B.N. 33 051 775 556 Trade mark of Telstra Corporation Limited

T E LSTRA ID REQUIR E M E N T S F O R E N T E R I N G I N TO A CO N T R A C T F O R A PO ST PA I D TELSTRA MOBILE SERVICE 100 POINTS REQUIRED.


Personal Applications (Private and Sole Traders)
All applicants must provide one form of Original Primary Identification and a minimum of one form of Original Secondary Identification. Requirements are split into primary and secondary. NB: ID sighted must be current, achieve a minimum of 100 points and be an original copy.

Company and Government Accounts


All applicants must provide a letter of Authorisation/Purchase Order (dated within 60 days of purchase) plus one form of Original Primary Identification and a minimum of one form of Original Secondary Identification.

Primary ID
Australian Passport (with photo and signature) Australian Drivers Licence with photo and signature (WA Drivers Licences accepted) Police/Defence Force ID (with photo) Credit Card (with photo and signature) Blind Citizens Australia Identity card (with photo and signature) Shooters Licence (with photo and signature) Birth Certificate or original Birth Extract (need marriage certificate if name changed through marriage) International Passport Date of visa must expire after the contract end date

Available Points
70 60 60 50 50 40 40 30

NB: Original Authorisation Letter on original company letterhead or Purchase Order signed by the company representative.

Primary ID
Australian Passport (with photo and signature) Australian Drivers Licence with photo and signature (WA Drivers Licences accepted) Credit Card (with photo and signature) Police/Defence Force ID (with photo) Blind Citizens Australia Identity card (with photo and signature) Shooters Licence (with photo and signature) International Passport Date of visa must expire after the contract end date

Available Points
70 60 50 60 50 40 30

Secondary ID

* Current Telstra customer greater than 12 months+ Aged Pension card * Credit, Debit, ATM cards (Australian financial institution cards only) * Mortgage documents (letter of offer/contract) * Certificate of Title Valid Australian Proof of Age Tertiary Student ID card with photo Social Security card Disability Pension card Health Care card * Private Health Insurance membership card Paper Drivers Licence (e.g. interim licence) Employment ID card (with photo) Employment ID card (without photo) Drivers licence (international/overseas) * Adoption or Marriage certificate * Electoral roll records * Medicare card * Local Council rates notice * Statement of account from financial institution * Gas, electricity, vehicle registration bills less than 12 months old
* +

Available Points
70 40 40 35 35 35 25 25 25 25 25 25 40 30 25 25 25 25 25 25 25

Secondary ID
* Telstra company account greater than 12 months Electricity company account less than 6 months old Gas company account less than 6 months old Water company account less than 6 months old Local Council company rates account less than 6 months old Company Credit Card Employment ID card (with photo) Employment ID card (without photo)
* NB: ID must be current * Customer must supply bill less thsn 6 months old.

Available Points
70 40 40 40 40 40 40 30

Business Rules
New post-paid connects on Next G 3G and GSM networks. Does not include pre-paid services. Does not include handset upgrade to an existing Active service. Telstra reserves the right to change or withdraw any part of the identification criteria without any prior notice.

Corporate Customers
 xisting Corporate or Government customers and their authorised representatives who have an established E agreement with Telstra, i.e> 6 months, will NOT be required to undergo the full 100 point ID check. An original letter of Authorisation or Company Purchase Order must still be provided. The representative must produce a security pass or company ID, the details of which should be recorded on the application. NEW Corporate or Government accounts MUST COMPLETE AND SUBMIT the 100 points ID requirement.

 nly one form of ID may be sourced from document types marked with an * E.g. one credit card and/or one rate notice will be accepted. O Customer must show bill less than 6 months old.

Unacceptable ID
The following forms of ID are amongst those considered as unacceptable for both personal and company accounts: - Any identification which has expired - Photocopies of ID - Club cards (e.g. RSL, AFL, League clubs, etc) - Store cards (e.g. Myer/Grace Bros, David Jones, Katies, Cash Converters, Sportsgirl, Esprit, etc) - Non Tertiary Student ID - Housing Commission/Rent Assistance cards or passbooks - Business Cards - Group certificates - Frequent Flyer cards - NSW birthcard

Current Telstra Mobile Customer upgrading to a contract


All applicants must provide one form of Original Primary Identification or two forms of Original Secondary Identifications. NB: Company upgrades require a letter of Authorisation/Purchase Order.

HAVE YOU GIVEN THE CUSTOMER TELSTRA'S MOBILE SERVICES BOOKLET?

TELSTRA BUSINESS MOBILE PLUS PLANS TRANSFER OF OWNERSHIP FORM


FORM C

1. EXISTING ACCOUNT HOLDER DETAILS Account Name/Account Holder Title Surname Existing Account Number

3. ADDITIONAL DETAILS FOR INCOMING ACCOUNT HOLDER (a) Other Telstra Services in Account Holder Name Given Name

Brown
ACN/ABN/ARBN City/Suburb

John

(b) Account Contact (if different from above) Title Surname Phone
( )

2 34 5 67 8 9 1 0 1 1 1 2 13 Maintown 1234
Postcode

Trading Name (if applicable) Account Holder Address Email Address

123 Main Street

2. DETAILS OF ACCOUNT HOLDER TO WHOM SERVICES WILL BE TRANSFERRED TO BE COMPLETED BY INCOMING ACCOUNT HOLDER Important Do not sign this application unless you have received and read the Business Mobile Services What you need to know when signing up Booklet and Telstras Protecting Your Privacy statement. Account Name/Account Holder Title Surname Given Name Trading Name (if applicable) Account Holder Address Email Address

Previous Address (if less than 12 months at current) City/Suburb Period at previous address
Years Months

Years of Incorporation (Companies only)

M A
Phone
( )

ACN/ABN/ARBN

City/Suburb

E L P
Fax Number
( )

O F
PRIMARY (at least one form) 1 2

Billing Address (if different to Customer Address)

(c) Personal Identification Sole Trade, Partnership and Unincorporated Accounts only Enter details in relevant fields (e.g. do NOT enter credit card number if used) Date of Birth / /
Document Type Points Doc/Acc.No. Date Issued Expiry Date D.O.B.

M R
( )

Given Name

Fax Number City/Suburb Postcode

SECONDARY 1 (at least 2 one form) 3 TOTAL POINTS (must be 100 minimum)

4. USER DETAILS (if different from Account Holder details in 2) Title Surname Given Name 5. COMPANIES, INCORPORATED ASSOCIATIONS AND GOVERNMENT DEPARTMENTS Verified ID of Company Representative (e.g. Employee Card, Corporate Credit Card) Title Surname Given Name Type of ID Expiry Date
/ /

Postcode

Postcode

Letter of Authorisation OR Purchase Order No. Directors, Committee Members or Authorised Government Representatives (if different from Account Holder Details) Surname Given Name Phone Number
( ( ) )
THIS FORM REMAINS THE PROPERTY OF TELSTRA

Industry Type (if applicable)

C178 11-10

Registered trade mark of Telstra Corporation Limited A.B.N. 33 051 775 556 Trade mark of Telstra Corporation Limited

6. DETAILS OF SERVICE TO BE TRANSFERRED


Casual ($35 only) Member Plan (12 month) Member Plan (24 month) Phone Plan (24 month) Net Ready MMEP

Mobile Service Number*

$10 $25 $35 $45 $65 $85 $100 $120 $130 $150

A B C D E

0:4: 0:4: 0:4: 0:4: 0:4:

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9. EXISTING ACCOUNT HOLDER OWNER ACCEPTANCE FOR TRANSFER OF OWNERSHIP ONLY By signing this section, I agree that: i) at the time Telstra accepts this application, Telstra will transfer the service(s) listed in Section 6 to the Account named in Section 2 on the terms set out on this application form; ii) I will be liable for all fees and charges incurred in relation to these services at the time that Telstra accepts this application; iii) any requests for variation, suspension or cancellation of the service(s) after this date may only be made by the New Account Holder; iv) Telstras commitment to privacy is set out in Telstras Protecting Your Privacy statement I have received from Telstra; v) Telstra may obtain information about me, including a consumer credit report from a credit reporting agency, and may use and disclose personal and credit information about me as set out under Privacy considerations on the back of this form. I warrant that all information in Sections 1 and 6 is true and correct. If I am the Authorised Signatory, but am not the Existing Mobile Service Owner, I warrant that I am authorised to sign this form on the Existing Mobile Service Owners behalf. Existing Service Owner Name Date Existing Service Owner/Authorised Signatory

EOM

BES

BIS

7. VALUE ADDED SERVICES DETAILS (IF APPLICABLE) Choose your additional Monthly Data pack: Amount $_________________ (incl. GST) Service Level Pack (not available on $10, $130 or $150 Plans): Untimed Voice (not available on $25 or $100 Plans) $10 Free MessageBank Diversion and Retrieval $5 SMS and MMS Pack $10 SMS and MMS Pack Choose your messaging option ($150 Plan customers only): Free MessageBank Diversion and Retrieval Free MessageBank Diversion and Retrieval and free Voice2Text messages

8. DEALER AGENT AUTHORISATION I am satisfied that the details provided on this form apply to the Account Holder and that the Account Holder/Authorised Signatory has shown me 100 points of current identification (in original form) to meet Telstras ID requirements. I confirm that I have provided a copy of the Business Mobile Services What you need to know when signing up Booklet, written program and service details and Telstras Protecting Your Privacy statement to the Authorised Signatory or to the Account Holder. I nominate the equipment described above for participation in the promotional package. I confirm that I have explained to the Account Holder that they may incur an early termination charge if this application involves an upgrade or a recontract of their existing Telstra mobile service that is still within a minimum term. NAC Operator Dealer

Sarah

Name of Dealer/Agent Representative (please print) Signature of Dealer/Agent Representative

Telstra Shop

John Citizen

M A

E L P
5 67 1 0
Premise Code

Authorisation No.

10. ACCOUNT HOLDER ACCEPTANCE IMPORTANT: Please read these terms, the terms on the back of this form, the pricing brochure we give you and our Business What you need to know when signing up Booklet (Booklet). If there is anything you dont understand, please speak to the dealer or us. By signing this form, you are acknowledging that you have read and agree to be bound by the terms in this form, as well as Our Customer Terms. You agree: Under Our Customer Terms, we can change the terms and prices of your plan. The summary of Our Customer Terms sets out how we can do this. If you use your Telstra service overseas, you will be charged for international roaming. If you use mobile data services overseas, it wont come out of your included data, and unless you take up a separate plan, you will be charged $15 per MB. We have explained to you that you will be charged for calls you make or for data you use in excess of, or which is not eligible to draw from, the included calls or data on your plan. The terms and conditions set out the types of calls which are not eligible. We have tools you can use to monitor your data usage and we recommend you sign up for these. You have received the Booklet which includes a copy of Telstras Privacy Statement Protecting Your Privacy. All information you have provided in this application is correct and that if you are not the Account Holder, you are authorised to sign this form on behalf of the Account Holder. You may be able to use your Telstra mobile services to purchase goods, services or content from a third party. If you do so, Telstra will debit the charges for the content, goods or services from your account. If you dont pay Telstra when due, Telstra may cancel your service. Account Holder Full Name (please print) Account Holder/Authorised Signatory

O F
John Brown

M R

2: K : 2 : 7
Date

Date

01/ 09 /10

01/ 09 / 10
C178 11-10

Telstra Mobile phones may interfere with sensitive biomedical electronic devices check with your specialist before use.
THIS FORM REMAINS THE PROPERTY OF TELSTRA

Registered trade mark of Telstra Corporation Limited A.B.N. 33 051 775 556 Trade mark of Telstra Corporation Limited

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