@ PLDT

PLD 3A REV 05/16

FOR RESIDENTIAL USE

No.RB 7775910
C U STOMER IN FORMATION SHEET
(C I S)
S.O. NO.
NEW APPLICATION CHANGE of DATE * ACCOUNT No.
OWNERSHIP /
POSTPAID WIRED LANDLINE
SUPERSEDURE
POSTPAID WIRELESS LANDLINE (PLP) CUSTOMER No. TELEPHONE No.
@ OTHERS

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BÏRTHDATE (Monr õaywearj SÊx’ CIVIL stATUs șliizrœsniP. ATR ŒO.
fOrfOrø;gnørsÿ
M F hinge Married Othera Filipino Others

țDENTIFICAT ÎON CARD {eny oÊ he Êo//a 'ing W/N. Or/v’er s License, ARC /O, žgSTS/5. Rogers /O, Cu nf Company /O, Sep-*6rp. Efienior hitmen /Oÿ
F'HYSIC ADDRES.S {where the telephone will be installed)

Owned, Rented Om
Yes
Owned No Managed
Tenant

EMAIL AÖD,RES'S

Do you own a PCT

yes
Mo WoME- lfathome, whols/aœyourlSP/s2
fYEœ.peasecheok Dome4aowDD
OveœeaęMDD Business

E MPLOYME NT STATUS Eh/lPLOYER"e / ’BUSINESS NAME

EMPLOYER's / BUSII’IESS ADDRESS

OFFICE TEL. No.

MONTHLY INCOME

CARDh4AME/TYPE CARDWo.

rOR Would you like to automatically charge your monthly PLDT bill to your credit cerd account?

EMPLOYER’s / BŁ/SINESS NAME & ADDRESS

POSITION

F URE9
CALLER ID BUNDLE (caiier io, cam ror+araing, speed caiiingj
NDD IDD CALL WAIT ING BUND LE {Ca// We it ing. C all Forwa rding, Spee d C ailing)
MEG A B U ND L E (C'aller ID, Cell Weiiing, Cell For 'erding. Sp e e d C elling) C ALL BAR RI NG ( PLDT 1 08 / 1 09. Tot aI CaII Ba rri ng )
SUP E R B UNDLE (Mega Bundle + 3-Party Conferen ce) OTH ERS

With unlim”ited local

High-speed broadband service
for personal needs T E PA D calls, unlim”ited internet
and exclusive PLDT
services

(U nlimited DSL + Landline) (I-fill Speed OSLj PI a n 18 4 9

UN łT PRICE
Requires landline subscription
PI an 2 09 9 Fr ee Un it
PI a n 99 0 PI an 999
P1 a n 3 0 9 5
PI a n 1995 Ot her s
PI a n 12 99
PI a n 4 1 0 0
PI a n 3 00 0
@Others 0Ihers F ib r PI a n 4 000

(ALL Ø Wimd/wiæless
Landline
Wired/wiæless
Landline
Premium
& unlimited
WiFi service
+ P300 MSF
(for existing landline only & Call All Subscribø¡s)

+ P150 MSF

LLL Call All

outside the home
(for existing DSL & Telped Subsnäbers only)

Service Bundle
 TELEPHONE ATTACHMENT OTHER THAN PLDT-PROVIDED UNIT
Plan 850 (Ma inline + 1 Call All SIM) PIa n 899 IMPORTANT h you inteñd to attach a devicø to the telephone serviœ, check the appropriate
nem/s below. Notwithstanding” ãny indications tó the œntrary, the attachment of any devi¢a
PI a n 12 29 to PLDTs telephone service shall be subject to pńor approval and payment of appliœble
Plan 1100 (Mainlin e + 2 Cat I All SlMs) charges, if any. PLDT will institute approprìate acôori for any disallowed/undedarœl
0 PI a n 1 4
59 attachment to the telephone sewiœ.
Plan 1aso ‹uainiine + a caii aii sił•u› . , ” Modem . Fax Machine Tel Set