Digi
CelcomDigi Tower
No 6, Persiaran Barat, Seksyen 52
Petaling Jaya, 46200 Petaling Jaya,
Selangor, Malaysia
Copyright 2023 CelcomDigi Berhad (Formerly known as Digi.Com Berhad)
[Registration No. 199701009694 (425190-X)]
SERVICE ACCEPTANCE FORM
Please use Capital Letters for Name, Address and Equipment Information
Service Order ID
*
Customer Name
*
Customer Email
*
example@example.com
Contact Number
*
Site Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Distance to Site
*
Within 120km
121km and above
Google Map Screen Capture
*
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You are required to provide Google Map for distance above 121km
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Speed
*
50 Mbps
100 Mbps
300 Mbps
500 Mbps
800 Mbps
1 Gbps
Type of Customer
*
Retail
Enterprise
Nature of Work
*
Installation
Restoration
Returned Order
FTTR - Site Recce
Installer Company Name (manual input - outdated)
Installer Company Name
*
Please Select
ALLO
LOGIC
CTS
Samudra
Solara
TDC
WCWL
Digi Business
Suriatel
YCOM
Rul Synergy
Sakol
ETD Makmur
A copy of eSAF will be sent to Installer's company email address as registered with Digi
Installer Company Email (default)
Installer Name
*
Installer Company Email (alternate)
example@example.com
Installer Signature
*
Fibre Provider
*
Please Select
CTS
OB
TDC
TM
FTTR
ALLO - DIGI
ALLO - CELCOM
Equipment Information
Download Speedtest - LAN (Mbps)
*
Please key in numeric with 2 decimal points
Upload Speedtest - LAN (Mbps)
*
Please key in numeric with 2 decimal points
Speedtest Picture (LAN)
*
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Download Speedtest - WiFi (Mbps)
*
Please key in numeric with 2 decimal points
Upload Speedtest - WiFi (Mbps)
*
Please key in numeric with 2 decimal points
Speedtest Picture (WiFi)
*
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of
Radius ID
*
Router Model
*
Skyworth RN685-AX3000 Wireless Router
TP-Link EX510 AX3000
Zyxel EX3300-T0
FTTR 1+1
FTTR 1+2
FTTR 1+3
Other
Router Serial Number
*
Router Serial Number Picture
*
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Faulty Router Serial Number
Modem Model
*
ZTE ZXHN F600
Other
Modem Serial Number
*
please insert correct Modem SN
Modem Serial Number Picture
*
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Mesh Model
TP-Link EX510 AX3000
Skyworth RN685-AX3000 Wireless Router
TP- LINK -X20 Ax1800 Mesh
Mesh Serial Number
*Only applicable for Mesh subscribers
Mesh Serial Number Picture
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*Only applicable for Mesh subscribers
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of
Dead On Arrival (DOA)
Splitter Port Number
Not Applicable
Remarks as below:
Extra Cabling
Not Applicable
5m
10m
20m
Other
Installer Remarks:
Date Completed
*
-
Day
-
Month
Year
Date when job is completed
*Below section to be filled up by Customer
Declaration
*
I hereby confirm that the equipment/service installation/maintenance is acceptable and to my satisfaction.
Customer's Signature
*
Customer Name
*
Customer I/C Number
*
Date
*
-
Day
-
Month
Year
Customer's comment
Disclaimer. Please note that this form is part of the general Terms & Conditions, all work shall be deemed completed and billing instruction shall proceed to you accordingly.
Generated File Name
https://fibre.celcomdigi.com/
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