PART B: application to be completed by new account holder

(Please complete ALL fields to avoid delay or rejection of your request)

Please write your details in block LETTERS

PART A: TRANSFER of service
to be completed by current account holder
Optus Networks Pty Ltd.
ABN 92 008 570 330

Change of Account Holder

Telephone, Optus TV and
Optus Broadband Residential

Title

Title

Surname

Are you known by any other name/s?

Middle Name
Please ensure that all products/services that are to be changed to the new account holders name are
ticked below to avoid delay or rejection of your request.

Yes

Yes

No

No

No

Residential Address

Postcode
Years

Time at current Residential Address (enter number of years/months)

Mailing Address

Months

Postcode

Previous Home Address (if less than 2 years at current address, this includes overseas addresses.)
Postcode

@optusnet.com.au

Existing Username
Optus broadband Cable, DSL, DSL DIRECT

Yes

Time at previous Home Address (enter number of years/months)

No

Current Residential Status:

Account Number
@optusnet.com.au

Existing Username
fixed line telephony

Yes

No

Account Number
RETURN BY FAX TO 1800 100 147
OR SEND TO CONSUMER RESOLVE
PROVISIONING, LOCKED BAG 31001,
FLINDERS LANE,
VICTORIA, 8009

Yes

If yes, what are those name/s?

OPTUS ACCOUNT DETAILS (Tick the services that will be changed)

Account Number

office use only

I verify this customer
has been credit checked

Middle Name

Please list one account holder only; multiple account holder requests will be rejected.

First Name

Optus dial-up
Note: Not all products
are available in all areas.

Surname

First Name

Account Number
Service Numbers

1.

2.

3.

4.

optus tv

Years

Renting

Business No.

Mobile Phone No.

Boarding

Buying

Months

Living with parents

Residential No.
Date of Birth dd/mm/yy

Drivers Lic. No./Passport No.

Credit Cards (tick if owned by applicant) Visa

MasterCard

Diners

Amex

Card Type

First 6 digits

Last 4 digits

Expiry Date

Card Type

First 6 digits

Last 4 digits

Expiry Date

Please provide your employers name and your occupation/industry or whether you are a student/homemaker/retiree or pensioner etc
Yes

No

Account Number
optus metv

Owner

Yes

No

Account Number

Time you have been employed/student/homemaker/pensioner/retired etc

Previous employment time
Years
Months
Income $

I understand that this is a cancellation of my existing agreement and I agree that all unspent
monthly charges paid by me in advance will be credited to my account and then charged to
the new holders account. I also consent to the transfer of my service to the new owner. As
this request may not happen immediately, I agree that I will make arrangements with the new
account holder for any interim costs.
I understand when transferring the Optus MeTV service to another name, the new account holder
will have access to my previous purchasing history on the service.

Income period

per week

Years

Months

per fortnight

per month

per annum

Please attach a copy of a current utility bill, which confirms the new nominated account holders name and address. If you are an
international student please attach a copy of your student visa.
NB: Optus Local customers will be placed on current Telephone Call Plans. If you require a change to your current Telephone White Pages Listing please
contact White Pages on phone: 1800 810 211 or via facsimile 1800 639 169.

Please nominate the person you would like to have Third Party Authority (TPA)
(NB: this person may have limited access to your account for either enquiry or maintenance purposes)

Name

TPA DOB dd/mm/yy

Please nominate a 4 digit pin (NB: the person who quotes this PIN will have FULL access to the account)

Account Access Pin

Final Billing Address

Postcode
MUST BE SIGNED BEFORE THE OWNERSHIP IS TRANSFERRED
Signature
NB: A charge may apply for changes of account holder.
1073094 01/12

Date

PART C: Important Notice AGREEMENT to be completed by the new applicant

Please read and sign below By signing this form I acknowledge that I have read and understood the information on the back of this form
and how Optus handles information about me (Personal Information). I also give Optus my consent to obtain and use credit information about me,
including information about my consumer credit history (eg. household and personal financing) and if applicable, my commercial credit history
(eg. as a sole trader). I also agree to pay all charges incurred plus outstanding equipment charges for the Optus service(s) that I have chosen.
Signature:

Print Full Name:

Date:

CHANGE OF ACCOUNT HOLDER TELEPHONE, OPTUS TV AND OPTUS BROADBAND RESIDENTIAL

SUMMARY OF THE STANDARD AGREEMENT FOR SUPPLY OF THE OPTUS LOCAL, OPTUS LOCAL, OPTUS LOCAL DIRECT, LONG DISTANCE SERVICE, OPTUS LOCAL ACCESS RESALE, OPTUS CABLE INTERNET SERVICE, OPUTS DSL DIRECT SERVICE,
THE OPTUS METV SERVICE AND THE AGREEMENT FOR OPTUS TELEVISION FEATURING FOXTEL (CONSUMER)
OPTUS NETWORKS PTY LIMITED ABN 92 008 570 330 OPTUS INTERNET PTY LIMITED ABN 14 083 164 532, AND OPTUS VISION PTY LIMITED ABN 50066518821
NOVEMBER 2011
IMPORTANT CUSTOMER INFORMATION YOUR RIGHTS AND OBLIGATIONS
The Optus Local, Local Direct, Local Access Resale and Long Distance Services
are supplied by Optus Networks Pty Limited. The Optus Broadband Services
(Cable Internet and DSL Direct) are supplied by Optus Internet Pty Limited. The
Optus MeTV service is supplied to you by Optus Vision Pty Limited. The Optus
Television featuring FOXTEL Service is supplied to you by Optus Vision Pty
Limited as agent for Optus Vision Media Pty Limited.
This form constitutes an application by you to acquire from Optus Networks
Pty Limited, Optus Internet Pty Limited and Optus Vision Pty Limited(us) the
Optus Local, Optus Local Direct, Optus Local Access Resale, the Optus Long
Distance Service, the Optus Cable Internet, the Optus DSL Direct Service, the
Optus Television featuring FOXTEL Service and/or the Optus MeTV Service (the
services).
The agreement is made up of this application, the consumer terms, the
service descriptions, standard pricing tables and any relevant appendices.
In the case of Optus TV featuring FOXTEL, the agreement is made up of
this application, the consumer terms, the Optus Digital Television Terms and
Pricing and any relevant appendices. The agreement contains full details
of each service and the terms and conditions of supply of each service
including charging, billing, term and cancellation. This document contains
a brief description of the key terms of the agreement. A copy of all the
agreement together with a more in-depth summary is available on our website at
www.optus.com.au/standard agreements or on request.
YOU SHOULD CHECK THE TERMS OF THE AGREEMENT CAREFULLY
DESCRIPTION OF THE OPTUS LOCAL (LAT and LAD), OPTUS LOCAL ACCESS
RESALE AND OPTUS LONG DISTANCE SERVICE
The Optus Local Access Telephony allows you to make and receive calls over our
Cable Network from a standard telephone. This service can be provided to you by
using an Optus Embedded Multimedia Terminal Adaptor (EMTA) located within
your premises. This device also allows you to access Optus Cable Broadband. You
may only access the Service using Equipment, including the EMTA, supplied by
Optus and ACMA approved telephone equipment. You agree to take reasonable
care of any Equipment and that if you fail to do so, or it is damaged, lost or stolen,
you will be responsible for the cost of repair or replacement. You must return
it to us on our request within 14 days, if you do not, we may charge you the full
replacement cost.
The EMTA will not operate in the event of a mains power failure unless you install
and charge the battery provided to you (only available with the Standard Wired
EMTA) or install an Uninterrupted Power Supply (UPS) for the wireless EMTA. It
is your responsibility to test, order and change the battery when required. The
battery may be re-ordered from Optus at a cost.
If you decide to have Wireless EMTA, this does not have the battery facility.
Customers with a serious illness, life threatening condition, back to base home
alarm systems or who require disability services which require an uninterrupted
telephone line must install the battery in the standard EMTA or organise a UPS
for the Wireless EMTA.
The Optus Local Access Direct allows you to make and receive calls via an access
line connected to our direct network from a phone located at your premises.
The Optus Resale allows you to make and receive calls via Telstras network from
a phone located at your premises.
The Optus Long Distance Service allows you to make calls, including national
and international long distance calls and calls to mobile phones. You can make
and receive operator assisted calls, as well as a range of reverse charges calls.
DESCRIPTION OF THE OPTUS BROADBAND SERVICE (CABLE AND DSL DIRECT)
INTERNET SERVICE
The Optus Broadband Service is a broadband internet service and provides access,
SingTel Optus Pty Limited ABN 90 052 833 208

via our network, via our network, to the Internet and related services. The services
provide an always on or constant connection to the internet and related services.
It is not available at all locations or premises and is only available if your premises
can be physically connected to the Optus network.
DESCRIPTION OF THE OPTUS TELEVISION FEATURING FOXTEL SERVICE AND
OPTUS METV SERVICE
The Optus Television featuring FOXTEL Service provides a selection of television
channels via our network, including free to air channels; you with an opportunity
to order and view pay per view or on demand programmes that we may offer from
time to time; and you with an opportunity to take advantage of certain interactive
services that we may offer from time to time. The service is only available at
premises which are physically connected to our network.
Optus MeTV is a service through which digital television is delivered to you via a
fixed broadband service and via a free to air television aerial connection.
It is accessed using the Optus owned equipment, additional equipment and other
equipment. Available only when you fulfil the eligibility criteria.
Data Usage: If your linked Optus account is an Optus DSL Account, data usage
generated by the purchase and/or download of content will be charged and
credited back to you and your broadband service may be throttled if you are very
close to your data limit. Charges may apply to data usage generated by downloads
and uploads associated with meta-data, User Interface components, images and
graphics, YouTube on TV, Applications, EPG Information and software updates.
You may only use the recording functionality of the service for viewing programs at
a more convenient time at your nominated residential address.
TERMS IN SERVICE DESCRIPTION FOR OPTUS TELEVISION ON FEATURING
FOXTEL SERVICE THAT SUPERSEDE CONSUMER TERMS:
Certain terms in the Service Description for the Optus Television featuring
FOXTEL Service supersede the Consumer Terms that apply to that service. In
summary these are:
(1) we will take reasonable care not to cause any damage to the premises when
undertaking installations, inspections and maintenance of the service. Despite
taking reasonable care, we may cause damage to the premises during the
course of installation, inspection and maintenance of the service. If this
happens we are not liable for that damage;
(2) our rights to change the agreement in the Services Description supersede
those in the Consumer Terms;
(3) if you suspend your service under the Service Description you are not required
to pay the access fees for the service during the duration of the suspension;
and
(4) the definitions in the Service Description replace the definitions in the
Consumer Terms to the extent that those definitions are inconsistent with
those specified in the Consumer Terms.
SUMMARY OF CONSUMER TERMS
Changing the Agreement: We may change the agreement by: complying with the
Telecommunications Act and, in those circumstances set out in the agreement
only, by giving you 21 days notice in writing of the change and allowing you to
cancel the service within 42 days of giving notice without paying fees or charges,
other than those set out in the agreement.
Personal Information: We may collect, use and disclose Personal Information
about you for purposes related to:
the provision of credit and the services or products or services of other Optus
group companies. If you do not supply the necessary information, we may
refuse or limit credit for the service;
the supply of information about Optus group company products or services

and products and services of other organisations. You may opt out of receiving
communications not related to your account or legally required by contacting
Customer Service;
supplying information to credit reporting enquiries, credit providers and related
and unrelated third parties, but only for the purposes set out above.
We may be required or permitted by law to collect, use or disclose your Personal
Information from or to organisations such as the operator of the Integrated Public
Number Database, emergency services organisations and law enforcement
agencies. Subject to applicable law, you may access your Personal Information
by contacting us. Our Privacy Policy is available at optus.com.au/privacy or by
contacting Customer Service.
Charges (see Standard Pricing Table)
You must pay all charges incurred for the service, even if you did not authorise its
use, the service is unavailable or you are unable to access it. We may ask you to
make a pre-payment usage charge or an interim good-faith payment.
We may offer promotions or offers in connection with the service (Special). If you
accept a Special, the price and terms of the Special will prevail until the Special
expires and then the full terms of the agreement will apply.
Payments
If you do not pay your bill by the due date, we may charge you a late fee, suspend
or cancel the service (in which case we may charge you a fee), engage a mercantile
agent, institute legal proceedings against you and on-sell any unpaid amounts to
a third party.
Paper Invoice Fee
A fee will apply if you choose to receive a paper bill posted to you. To avoid this fee
you may change to an electronic bill sent to you by email by enrolling at optus.
com.au/myoptusaccount. Electronic bills will be phased in over time and may
not be available to you immediately. If electronic billing is not available to you,
we wont charge you the fee. We will write to you to advise you of the availability
of electronic billing and before any fee is charged. If a paper invoice fee has been
applied to your account, you will not be charged the $2.20 non-direct debit fee.
Payment Processing Fee
A payment processing fee will be charged if you pay your bill by credit or charge
card or via an Australia post outlet. See optus.com.au/payments for details.
Single Bill
We may place one or more services that you have with us on a single bill. At
point of sale you may choose to have all services billed individually. If you receive
a single bill, afterwards it may not be possible to obtain individual bills for your
services.

Suspending or Cancelling the Service

Your right to cancel the service: You may cancel the service by giving 30 days
notice or if we breach a material term of the agreement. If a fixed length
agreement is not cancelled before the end of the minimum term the agreement
will become a non-fixed length agreement.
Our right to suspend or cancel the service:
We may suspend or cancel the service in a variety of circumstances, including
if: any amount owing to us is not paid by its due date and you do not pay that
amount within 10 days of receiving notice from us, we reasonably consider you a
credit risk, you breach a material term of this agreement, or as otherwise set out
in the agreement. In addition, we may suspend the service if we need to repair
or service any part of the network or if we believe there has been an unusually
high use of the service.
If the service is cancelled, you authorise us to use any over payment on your
account/money paid in advance to pay for undisputed outstanding charges. If
there are no outstanding charges and the service is not a pre-paid service we
will refund on a pro rata basis any over payment. If you are required to pay for
the service by direct debit payment you authorise us to debit any undisputed
outstanding charges (including cancellation fee) from your credit card or bank
account. If the service is cancelled during the minimum term of a fixed length
agreement due to circumstances attributable to you, you must pay us the
cancellation fee and if we then reinstate the service, you may have to pay a
reconnection or reactivation fee.
If the service is suspended you must pay an access fee while the service is
suspended. You may be entitled on request to a refund or a rebate of access fees
for the suspension period if the suspension was not attributable to you. If it was
attributable to you, you may have to pay us a suspension fee and, if you wish to
reactivate the service, a reconnection or reactivation fee.
Liability
Your liability to us: You are liable to us for any breach of the agreement causing
foreseeable substantial loss to us. You are not liable to us for consequential loss
which is not a result of something you have done.
Our liability to you: Under the Australian Consumer Law, if you purchase goods
or services from us which cost less than $40,000, or which are normally acquired
for personal, domestic or household use, then certain consumer guarantees apply
to those goods and services. The consumer guarantees apply in addition to any
express warranties which are given to those goods and services. The consumer
guarantees apply in addition to any express warranties which are given. We accept
liability to you in accordance with the Australian Consumer Law and other laws:

Taxes

Except where otherwise provided under the Australian Consumer Law or other
laws:

Optus will charge you for taxes, including any GST for supplies made in connection
with the service.

we may be liable to you in connection with the agreement and the supply or
interruption of the service only to the extent provided in the agreement; and

Complaints and disputes

we are not liable to you for consequential loss.

If you have any complaint you may contact us. If we are unable to resolve your
complaint you may take your complaint through other avenues, such as the
TIO, ACCC or the Department of Fair Trading or Consumer Affairs in your state
or territory.

Customer Service Guarantee for Optus

Accessing the service for home use

You will be charged a connection fee for connection to our direct network. There
will be a short disruption to your telephone service of approximately 15 minutes on
the day that the service is activated. During this time you will not be able to make
or receive calls. Due to technical and commercial reasons it may not be possible
to connect you to more than one access line and/or to certain calling features.

You may have certain rights and remedies under the CSG or Customer Service
Guarantee. Further details available at acma.gov.au
Priority assistance
We do not offer Priority Assistance, however we offer Optus Special Assistance
Service (OSAS ). For details see optus.com.au/osas
Policies
The Optus Mobile Fair Go policy, Acceptable Use Policy and Local and Long
Distance Fair Go policy apply as relevant to your use of the services.
1073094 01/12