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Forms
Fixed Line (PSTN) – Application Form
Fixed Line (PSTN) – Application Form
Fixed Line (PSTN) Application Form
Step
1
of
3
33%
Dealer
Yes I am an active dealer (Please Tick)
New or existing account?
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I don't have an account
I have an existing account number
Account Number
*
Account Name
*
Dealer Information
Dealer Code
*
Dealer Name
*
Dealer Rep
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First
Last
Organisation Details
Organisation Name
*
ABN / ACN
*
Name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Title
First
Last
Position
Phone
*
Email
*
Billing Address
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Street Address
Address Line 2
City
State
Postcode
Afghanistan
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Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
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Cook Islands
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Guyana
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Iraq
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Isle of Man
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Jersey
Jordan
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Kenya
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Lao People's Democratic Republic
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Mali
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Martinique
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Mayotte
Mexico
Micronesia
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Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Service Details
Service Address
*
Street Address
Address Line 2
City
State / Province / Region
Postcode
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Connection Type
*
Transfer (Churn) an existing service
Connect a new service(s)
Services to be Transferred
*
Telephone Number
Please enter the telephone numbers you would like to transfer.
Number of New Connections
*
Please enter a number from
1
to
10
.
Product Name
*
BusinessLine Standard - $39.95 per month
BusinessLine Advanced - $95.41 per month
BusinessLine Max - $109.09 per month
Prices shown are exclusive of GST
Minimum contract term: 3 months
Call Rates
Flagfall Per Minute (per 30 second) Local Call $0.20 N/A National/STD Call $0.20 $0.20 Mobile Call $0.20 $0.30 Special 13/1300 $0.35 Rates shown are ex GST
Minimum contract term: 24 months
Call Rates Flagfall Per Minute (per 30 second) Local Call N/A N/A National/STD Call N/A N/A Mobile Call $0.20 $0.30 Special 13/1300 $0.35 Rates shown are ex GST
Minimum contract term: 24 months
Call Rates
Flagfall Per Minute (per 30 second) Local Call N/A N/A National/STD Call N/A N/A Mobile Call N/A N/A Special 13/1300 $0.35 Rates shown are ex GST
New Service Type
*
In-Place Telephone Connection - $59.00
Telephone line connection with a technician visit - $125.00
Telephone line connection with a technician visit (No previous connection/New Connection - $299.00
Price shown is exclusive of GST
Inplace Standard Connection
A working telephone socket exists from a previous connection and one of our technicians is not required to visit your property or premises.
Additional Connection
A telephone socket exists from a previous connection to a competitor’s network and one of our technicians is not required to visit your property or premises, but we need to undertake manual cabling activities within one of our exchanges.
Connection with Technician Visit
A previous telephone service existed at your property or premises and one of our technicians is required to visit your property or premises to reconnect existing suitable cabling in the following places:
Connection with Technician Visit to New Property
A telephone service has not previously been connected at your property or premises (although we may have previously installed cabling to your property or premises and you may be able to hear a soft dial tone).
The Applicant accepts and agrees to the TRUECOM Standard Form of Agreement, Fixed Line (PSTN) Service Description. The Applicant also agrees to the product specific details and pricing included in this application. The Applicant also confirms that he/she is 18 years of age or older. If the Applicant is a company then the person signing this form warrants that he/she is authorised to execute this Agreement on behalf of the company. You accept all responsibility for arranging, paying for and maintaining all cable required from the network boundary point, to the point where you wish to use the service. Billing of the service will commence within seven days of it being installed to the network boundary point, regardless of whether you have arranged any required additional cabling or not. ■ You will be required to provide technicians with access to your premises, for the purposes of installing the PSTN service. In most houses, the installation technician will either upgrade an existing telephone point; re-use a spare telephone point; or install a new telephone point. You agree that the type and location of the telephone point is at the installation technician’s discretion. ■ However in apartments, business premises and any other location with a Main Distribution Frame, you may need to arrange additional inbuilding cabling (at your expense) to bring the PSTN service from the Main Distribution Frame to your required location.
Name
*
First
Last
Please check box above
*
I agree to the terms and conditions above and have reviewed the Standard Form or Agreement (SFOA)
Please check box above
Signature
*
Please sign above using your mouse or touchpad and press SUBMIT when completed.
Comments
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