ADSL/NBN or Ethernet Relocation Upgrade Application Form

WHEN TO USE THIS FORM: 1. You are an existing Webvault customer with an ethernet, ADSL or NBN service. You are moving premises and/or you would like a change in speed.

Need Help with this Form?Call 1300 139 927 (Option #1) Email: support@webvault.com.auWeb: www.webvault.com.au

Your Account Information

Company or Business Name:*

Webvault Account Number

Contact Name for this Application*

Contact Email Address*

Contact Mobile Number*

Contact Telephone Number

Current Service Details

Site/End User Customer Name*

Service ID #

Service Type*

Existing ADSL Service Phone #*

Existing Service Address

Level/Floor #

Unit/Suite #

Current Street Address*

Current Suburb*

State*

Service Change Requests*

I wish to relocate my service to a new address.I wish to change the speed of my service.

New Service Address

NEW ADSL Service Phone #*

Enter the PSTN phone line number to use for ADSL at the NEW service address. This MUST be an active telephone service in order to proceed.

Level/Floor #

Unit/Suite #

NEW Street Address*

NEW Suburb*

State*

Please confirm the following Relocation Fees*

I understand that a one-time ethernet service relocation fee will apply of $250 AUD plus GST.

Please confirm the following Relocation Fees*

I understand that a build fee will apply as quoted by Webvault to relocate a fibre ethernet service.

Please confirm the following Relocation Fees*

I understand that a one-time ADSL relocation fee will apply of $150 AUD plus GST.

Please confirm the following Relocation Fees*

I understand that a one-time NBN relocation fee will apply of $150 AUD plus GST.

Site Contact Person

Site Contact Name*

The site contact is the person who will be available to provide access to the new or existing premises for installers and technicians.

Site Contact Phone*

Site Contact Email Address

Speed Upgrades/Downgrades

ADSL Service Options*

Annex-A Up to 24Mbps / 1MbpsAnnex-M Up to 24Mbps / 3Mbps

Annex-M requires an approved Annex-M modem to operate. and in some cases may affect the stability of your connection. The exact service speed is dependent on your distance from the telephone exchange.

NBN Service Options*

12Mbps / 1Mbps25Mbps / 10Mbps50Mbps / 20Mbps100Mbps / 40Mbps

Ethernet Copper (Pay Per Wire) Options

4-Wires Up to 10Mbps / 10Mbps6-Wires Up to 15Mbps / 15Mbps8-Wires Up to 20Mbps / 20Mbps

The exact speed of your pay per wire ethernet service depends on your distance from the exchange. Any service changes are subject to a full site qualification as well as the availability of wires and ports at your location.

Ethernet Copper (Fixed Bandwidth) Options

8Mbps / 8 Mbps10Mbps / 10Mbps20Mbps / 20MbpsOther

NOTE: Existing pay per wire ethernet services can NOT be changed to a fixed bandwidth service.

Ethernet Fibre (Fixed Bandwidth)*

10Mbps / 10 Mbps50 Mbps / 50 Mbps100 Mbps / 100 MbpsOther

Please confirm the following Speed Change Fees*

I understand that a one-time ADSL speed change fee will apply of $20 AUD plus GST and that additional monthly service charges as quoted by Webvault may apply to my service for any upgrades.

Please confirm the following Speed Change Fees*

I understand that a one-time NBN speed change fee will apply of $20 AUD plus GST and that additional monthly service charges as quoted by Webvault may apply to my service for any upgrades.

Please confirm the following Speed Change Fees*

I understand that a one-time copper ethernet speed change fee will apply of $250 AUD plus GST and that additional monthly service charges as quoted by Webvault may apply to my service for any upgrades.

Please confirm the following Speed Change Fees*

I understand that a one-time fibre ethernet speed change fee will apply of $250 AUD plus GST and that additional monthly service charges as quoted by Webvault may apply to my service for any upgrades.

Terms & Conditions of Relocation and Service Speed Changes

1. Service address relocations or speed changes do NOT affect the current contract period remaining (if applicable) for this service.2. A one-time relocation and/or speed change fee will be applied to your account for these service changes as specified in this application or as quoted by Webvault.3. All service changes are subject to a site qualification after the order is submitted, which will include a check on the availability of copper wires, fibre cores or ports at the telephone exchange .4. The relocation of a service to a new address is not always possible and is dependent on available coverage areas for each type of service.5. Service speed changes or relocations can sometimes result in an outage of your existing service while changes are being applied. Webvault takes no responsibility for any loss resulting from any outage of your service whatsoever.6. Where your services speed has been increased an additional monthly service charge will apply for that service upgrade as quoted by Webvault as is payable from the date the service is upgraded.7. Existing service speeds cannot be downgraded when still under a current contract period.

Authorisation*

I am an authorised representative for this account and approve the following changes to my ADSL/NBN/ethernet service. I have also read and confirm my agreement with the above terms & conditions.

Signed (Full Name)*

Position*

Application Date*

Date