Application-Cum-Agreement For Pacnet Service

CABLE BROADBAND RELOCATION CUM CHANGE OF MODEM FORM

Page 1 of 3 pages

Account Holder's Particulars
Name:
NRIC:
Current Mac ID:
Account number:
User ID:

I wish to relocate my current cable broadband installation address to the new premise. I am aware that there will be a relocation fee of $21.40 charged to my Pacnet account. My billing address will also be updated to the new installation address unless otherwise specified.
I wish to change my modem model and Mac id.

All prices are inclusive of prevailing GST.