WIRELINE PERMANENT DEACTIVATION FORM

COMPANY NAME: ____________________________________________________________________________

FILING DATE: _________________________________ DEACTIVATION DATE: _______________________________

DETAILS OF EXISTING SERVICE/S FOR DEACTIVATION

PLEASE ENSURE ACCURACY AND COMPLETENESS OF ALL INFORMATION REQUIRED.

SERVICE PROVIDER ACCOUNT NUMBER SERVICE TYPE SERVICE ID/ CIRCUIT ID BANDWIDTH /TEL # Point A (FROM Address) Point B (TO Address) CURRENCY & MRC

Please be reminded that PERMANENT DEACTIVATION will be implemented 30 CALENDAR DAYS after ACKNOWLEDGEMENT OF ACCEPTANCE of the duly accomplished PERMANENT DEACTIVATION FORM FOR WIRELINE DATA SERVICES or on the
DEACTIVATION DATE REQUESTED, whichever comes later. Moreover, PRE-TERMINIATION CHARGES shall apply to services that are deactivated before the contract expiration date.
If there are other Services currently bundled to the product, deactivation will also be effected for all services at the same time.
REASON FOR PERMANENT DEACTIVATION REQUEST

TECHNICAL FINANCIAL AND LEGAL COMPETITION TEMPORARY ARRANGEMENT

Not Available in new location Billing Concerns Product/Service Offer Special Event / One time occasion
Change of Product Company/ IT Re-structuring After-Sales Service End of Trial period
Service / Network Company / Branch Closed Customer handling Interim Product / Service
Cost Cutting Rates

Additional Notes [For completion of SPOC if there's other items that needs to be documented]

PREPARED BY: NOTED BY:

Signature over Printed Name of Customer / Position/Title Email Address Signature over Printed Name Signature over Printed Name
Authorized Representative Account Manager Industry Head
 NOTES/GUIDELINES IN COMPLETING THE FORM

A. Please ensure COMPLETNESS and ACCURACY of the Details to be encoded in the form.

B. PERMANENT DEACTIVATION FORMS that are incomplete, with missing and/or inaccurate details WOULD NOT BE ACCEPTED and would be returned for correction

C. If You are unsure with your Service/Product details, you may refer to your BILLING STATEMENT or ACCOUNT MANAGER

D. CLIENT NAME shall be your SEC registered name or the Name that is reflected in your Billing Statement

E. The FILING DATE shall correspond to the date when the form has been SUBMITTED for processing

F. The DEACTIVATION DATE shall correspond to the date when the services should be ACTUALLY Terminated.

G. Service Provider shall either be:

1. Innove Communications, Inc. (A Wholly-Owned Subsidiary of Globe Telecom, Inc.)
2. Bayan Telecommunications, Inc. (A member of the Globe Group of Companies)

H. The ACCOUNT NUMBER corresponds to the unique 9 DIGIT Number assigned to your account:
1. For Innove products, the numbering convention is 8XXXXXXXX
2. For Bayan products, the numbering convention is 7XXXXXXXX

I. The SERVICE TYPE shall be the same service or product as reflected in the Billing Statement/ Contract/ Proposal

J. The SERVICE ID/ CIRCUIT ID is the unique identifier of your service.

1. For Innove products, the numbering convention is IC-XXX-XXXX
2. For Bayan products, the numbering convention is usually a 6 digit Number or IC-XXX-XXXX

K. For BANDWIDTH /TEL #

1. For Data products, please indicated the most recent BW of the circuit based on your Billing Statement
2. For Fixed Voice or Fixed Broadband products, please indicate the Telephone number. For ISDN-PRI please indicate the Circuit ID of the Leased Line

L. For ADDRESS portion this shall be same as the definition in the Network Diagram/Design
1. Point A shall be defined as the FROM ADDRESS
2. Point B shall be defined as the TO ADDRESS

M. Please choose the applicable REASON FOR DEACTIVATION. You may write down other comments/reasons in the Additional Notes portion.

N. After checking the completeness and accuracy of the WIRELINE PD FORM, please forward to your ACCOUNT MANAGER to begin processing the request