Acknowledgement:
By submitting this form, you agree as follows:

you are the account holder of the DSL service(s) listed above, or are authorised by the account holder to transfer this service to Cybertel Telecom Pty Ltd
- the information provided in this form is true and correct;
- you have read and understood the terms of this transfer and the “privacy” section below;
- you understand that it is your responsibility to check the terms of your contract with your current DSL supplier to determine if there will be any consequences under that contract as a result of this transfer (such as an early termination payment).
- I have read and agree to all the terms and conditions in sections 4 to 6.

Terms of this transfer
The terms of this transfer are:
- Cybertel Telecom will supply your DSL service from the date the transfer takes effect (we will notify you when that happens);
- you will pay Cybertel Telecom for all charges associated with the service from the date this transfer takes effect;
- you will still be responsible to your current DSL supplier for any charges incurred and/or billed up to the date the transfer takes effect;
- Cybertel Telecom may refuse or cancel your service on the basis of its credit assessment of you;
- after the transfer, you may not be able to receive certain benefits you currently receive from your DSL supplier (e.g. discounts or specific product enhancements);
- you authorize Cybertel Telecom to act on your behalf to transfer your DSL service;
- if you require ongoing technical support for your DSL modem you will need to contact us to check whether we can provide that support;
- your DSL service will remain active with your current DSL supplier until the transfer takes place;
- you will need to contact your current DSL supplier about any faults with your DSL service until this transfer takes place; and
- you may experience an outage in your DSL service of up to 4 hours whilst the transfer takes place.

Privacy
You consent to Cybertel Telecom:
(a) obtaining a consumer credit report and/or information about your commercial activities and commercial credit worthiness from a credit reporting agency or any other business that reports on commercial creditworthiness; and
(b) obtaining credit information about you from other credit providers to assess your application for commercial credit, assess the status of any account you have with Cybertel Telecom (not just the account to which this application applies) or to collect overdue payments from you;
(c) disclosing credit information about you, including:
- permitted identification details; the fact that you have applied to obtain Cybertel Telecom services and the credit terms (if any) of those services;
- information in your application;
- the fact that in Cybertel Telecom’s opinion you have committed a serious credit infringement (if applicable)
- information relating to the conduct of your account, such as that payments are overdue, cheques of more than $100 that have been dishonoured when presented more than once or that payments are no longer overdue from you, to:
(i) credit reporting agencies for the purpose of obtaining a consumer credit report about you, creating a credit information file or including information in credit information file maintained by the credit reporter; and
(ii) credit providers named in a credit report, for the purpose of assessing this application for commercial credit, notifying other credit providers named of a default by you, exchanging information as to the status of your account where you are in default with other credit providers or to assess your
creditworthiness; or
(iii) collection agents if your account is overdue, for the purpose of recovering overdue moneys.
Cybertel Telecom requires its collection agents to treat information passed on to them in a confidential manner in order to protect the privacy of the customers concerned;
(d) using any personal information in your application form to provide, administer and maintain the services sought to be provided by Cybertel Telecom, prepare accounts for those services and for targeted direct or indirect marketing of other Cybertel Telecom products; and
(e) disclosing any personal information in your application form to outsourcing entities engaged by Cybertel Telecom to perform the functions above.

You also consent to your current DSL supplier disclosing credit and personal information relating to your service accounts with that supplier and service numbers to Cybertel Telecom to affect the transfer to Cybertel Telecom.

You can access and request correction of any credit information about you or any personal information relating to
you held by Cybertel Telecom. Please contact 1300 763 201 to obtain access to that information.

Other information
- You can contact Cybertel Telecom by phoning 1300 763 201 if you have any questions or complaints
about this transfer.
- Cybertel Telecom will notify you that the transfer of your DSL service has been completed within 2 working days of the transfer taking place.