Business Fixed Services - Application form - Du

Miscellaneous services One-time installation fee (AED) Quantity
Change of telephone number 100
Reconnection of suspended service 50
Business service shifting
Price available on quotation
Payment method
Cash Cheque Credit / debit card**
**Fill the credit card approval form.
NOTE: Telephone numbers will be provisionally allocated to the Customer. Prior to activation provisional telephone numbers are subject to change by du.
Customer should not publicise the provisional telephone number until confirmation of activation is received by the Customer. du shall not be liable for
any wasted expenditure or costs incurred by the Customer in printing stationery or advertising its business using a provision telephone number.
We agree by signing below that we have ordered the du services indicated on the attached du business service application form and that we accept the du business
Terms and Conditions as stipulated in the subsequent pages of this application form. We take full responsibility for the use of all du services provided to us.
Sometimes we have new products or special promotions which we think you‘ll find interesting.
If you would like to be kept informed, please tick here
Signature
Company stamp
Date
/ /
DD MM YYYY
For official use only
For direct sales
Account Manager name
Location ID
Account Manager ID Mobile number 0 5 5
Sales WO number
Customer ID number
For Indirect sales
Sales channel/Partner code Sales agent code Market code
Outlet code
Sales agent location
*Segment TA/PSME/BSME/SOHO.
Installation
Monthly
Total
Total