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Customer Details
Salutation
Name
Gender
Race
Date of Birth
ID Number
Nationality
Tuan/Puan
wan maslura wan othrar
FEMALE
Malay
29 Sep 1987
870929295186
MALAYSIA
POS Reservation ID
Agreement
Device
IMEI Number
601141554342
89601614040200244559
Mobile Service Voice
1DiGi MNP Prepaid
GPRS_Standard
PAYU BEST(Daily Max Cap RM8)
FN_DiGi NewBest
-
Permanent Address
Address 1:
Address 2:
Address 3:
City:
State:
Postcode:
Country:
Pasir Mas
Kelantan
17030
MALAYSIA
Declaration
(A) For mass/individual/corporate individual
Billing Information
Address 1
Address 2
Address 3
City
State
Postcode
Country
I [Name] ________________________________hereby;
(B) For company/business
I,[Name of Authorised personnel] ____________________________________, duly authorised by [Name
of Company]____________________________________, hereby,
declare that the above information is true and complete and I authorize DiGi to verify the
information furnished herein. In this regard, my consent for the disclosure of any of my
information in connection with credit and/or financial matters include my consent for DiGi to
disclose to any relevant third parties including without limitation, financial institutions, credit
agencies etc; and the said third parties to disclose such information and/or findings to DiGi.
agree and accept that by registering and/or continuing to use the products and/or services
chosen, I
i. accept that Terms and Conditions and the Data Protection Obligations as set out in
http://www.digi.com.my/tnc and DiGi Privacy Statement as set out at
www.digi.com.my/support/general/privacy.do forms an integral part of the terms and
conditions of the use of the said products and/or service;
ii. accepts that DiGi may revise and/or modify the Terms and Conditions, the Data
Protection Obligations and DiGi Privacy Statement from time to time and in the
event of such revision and/or modification, DiGi will communicate the same via
DiGis website;
iii. accepts that DiGi reserves the right to reject this application at DiGis discretion; and
iv. authorise as well as consent to personal information including sensitive personal
data, being processed by and where required, disclosed to classes of third parties
as identified by DiGi for the purposes of DiGi providing the said products and
services.
Note: The Terms and Conditions, the Data Protection Obligations and DiGi Privacy Statement are also
available via DiGis website, Online Customer Service and additional hardcopies of the same can also be
made available upon written request.
Date: _____________
Customer Signature
RM 0.00
RM 0.00
RM 0.00
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