Subscriber Contract
Fixed-Line Internet
Customer Centre – Business
4644 from T-Mobile numbers, 603 604 644,
business@t-mobile.cz
www.t-mobile.cz
T-Mobile
Customer Contract
Subscriber Contract
DSL number
Order number
T-Mobile Czech Republic a.s.
Tomíčkova 2144/1, 149 00 Praha 4
Company reg. no. 649 49 681, tax reg. no. CZ64949681
Registered in the Commercial Register administered by the
Municipal Court in Prague, Section B, File No. 3787
Legal entity, individual – entrepreneur
Information concerning the individual, person responsible or person authorised
Customer
to act on behalf of the legal entity.
Business name
Street
City
Postal code
Company reg. number
Tax reg. number
Name, surname, title
Street
City
Postal code
Birth id. no./date of birth 1)
Citizenship
1st ID document – number, validity
2nd ID document – number, validity
Representative
Name, surname, title
Street
City
Postal code
Birth id. no./date of birth 1)
Citizenship
ID document – number, validity
Contractual stipulations
Business Agent, code, address
Business Agent’s phone no.
Customer ID in TMPIS
T-Mobile and the Customer hereby enter into a Subscriber Contract. Upon the conclusion of the Subscriber Contract, Service Contract No.
, entered into with
T-Mobile or, as the case may be, České Radiokomunikace a.s. (“ČRa”), which was transferred to T-Mobile following the sale of a part of the business, will
automatically be terminated.
T-Mobile and the Customer have agreed that their contractual relationship established under the Subscriber Contract will be governed by Act No. 513/1991 Coll., the
Commercial Code, as amended. The content of the Subscriber Contract is defined by this Subscriber Contract, the General Terms and Conditions of T-Mobile Czech
Republic a.s. in force (the “General Terms and Conditions”), the Price List of Services in force (the “Price List”), the terms and conditions applicable to xDSL
migration/Internet ADSL (the “Terms and Conditions”) and by the conditions of other Services, if activated. If the Customer committed to the Minimum Monthly
Payment (“MMP”), he/she confirms to have read the MMP Terms and Conditions in force, which apply to the Customer. By signing the Subscriber Contract, the
Customer confirms that he/she has received these documents, read them and agrees with them without reservations. The Customer expressly confirms that he/she
has read and agrees also to the General Terms and Conditions of T-Mobile Czech Republic a.s. and the Terms and Conditions for Processing of Subscribers'
Personal, Identification, Traffic and Location Data effective from 1 September 2013, which will form an integral part of the Subscriber Contract from 1 September
2013. The Customer will be provided with electronic communications services defined by the Terms and Conditions, and Additional Services to the extent agreed by
the contracting parties.
The Customer has read and agrees with the terms and conditions of the services and offers activated upon the signing of the Subscriber Contract.
T-Mobile and the Customer have agreed that the duration of the Subscriber Contract is .
The Customer undertakes to use the Fixed-Line Internet service only at the installation address specified in the ‘Set-Up of Services’ section.
The Customer agrees that T-Mobile will process the Customer’s personal or identification data (“Data”) in compliance with the Terms and Conditions for Processing
of Subscribers' Personal, Identification, Traffic and Location Data and that T-Mobile may provide information on the company registration number, business name
and place of business for the purposes of Article 5 of the Terms and Conditions for Processing of Subscribers' Personal, Identification, Traffic and Location Data.
The Customer agrees that T-Mobile may obtain information on the Customer’s payment history necessary for the purposes of reviewing the Customer’s
request for entering into a Subscriber Contract from the database administered by the SOLUS association (www.solus.cz), of which T-Mobile is a member.
Declaration: I am well aware and agree that, from the date of signing of this Subscriber Contract, all services provided on my subscriber line identified by the
fixed-line telephone number specified in the ‘Set-Up of Services’ form (the “subscriber line”) until that date by Telefónica O2 Czech Republic a.s. (“Telefónica
O2”) will be discontinued and all services will be thereafter provided on the subscriber line by T-Mobile. I am further well aware that the services provided by TMobile may be different from those provided by Telefónica O2.
2)
Declaration: I am aware that, by ticking this request, all services provided on my subscriber line identified by the fixed-line telephone number specified in the
‘Set-Up of Services’ form (the “subscriber line”) until that date by Telefónica O2 Czech Republic a.s. (“Telefónica O2”), except for voice telephony services
(including all additional services), will be discontinued and services in the non-voice band will be thereafter provided on the subscriber line by T-Mobile.
I acknowledge that if the O2 Mini plan is activated on the subscriber line, which is being unbundled, along with a voice service, such plan will be changed to a
plan allowing the activation of the Fixed-Line Internet service in the non-voice band. 3)
I confirm that I am a subscriber in relation to the above-mentioned subscriber line or am authorised to act on behalf of such subscriber, and all information
stated is correct. I hereby authorise T-Mobile to order the services specified below. I am aware that, during the implementation of the orders sent to Telefónica
by T-Mobile in accordance with this authorisation form, Telefónica cannot guarantee provision of services without interruption and restrictions. 4)
Date
Signatures
Customer
T-Mobile/Business Agent
Platné od 1. 7. 2013
1)
If the Customer does not have a birth identification number, please fill in the
3)
date of birth.
2)
To be crossed when the customer orders shared access to the fixed-line local
loop via local loop unbundling (LLU)
To be crossed when the customer orders full access to the fixed-line local loop
via local loop unbundling (LLU).
4)
To be crossed always when the customer orders fixed-line internet services via
local loop unbundling (LLU); box 2 or 3 must also be crossed.
Service settings
Customer Centre – Business
4644 from T-Mobile numbers, 603 604 644,
business@t-mobile.cz
www.t-mobile.cz
Tariff plans
IP addresses
DSL number
DSL key
Tariff plan
Default IP address
Additional host IP addresses
Network:
Gateway:
Customer IP address:
Broadcast:
Mailing
address1)
Contact data and
passwords of the person
responsible
Fixed-Line Internet –
specifications
Business name
Name, surname, title
Street
City, postal code
Person responsible– full name
Administrator’s phone number
Contact phone number
E-mail
Password of the new person responsible (numerical) 2)
Password of the current person responsible
Password for blocking (numerical)
Fixed-line telephone number
Reference number
Current operator
TMCZ
Fixed-line telephone number 3)
Reference number 4)
Installation address
Billing and payment of
services
Name, surname / Company
Street, land registry no./street no.
City, postal code
Region
Statement of Services
Payment method 5)
Limit
Customer's bank
Account no./bank code
Billing period
E-mail
Contact phone number
electronic
Deposit on services
Discount on monthly fee
CZK 0
CZK
New Statement of Services
/
To be associated with current Statement of Services no.
To be associated with TMPIS ID
Other settings
Terminal devices
TMPIS identification
Language for communication
English
Device type
IMEI/SN
Activation code
Lease of terminal device
Installation by partner
Scheduled installation date6)
1810
yes
no
Service ID in TMPIS
1)
To be filled in only if different from the registered office, place of business, or resident
address.
2)
6)
To be filled in only if full access to the Provide A line is ordered (to an
existing telephone number based on LLU). TMCZ reserves the right to
To be filled in only if a new person responsible is appointed.
Platné od 1. 7. 2013
change the scheduled installation date in the case of material obstacles to
3)
To be filled in only if two-pair SHDSL is ordered.
the execution of the order y (missing documents, technical restrictions on
4)
To be filled in only if two-pair SHDSL is ordered.
the part of the contracting partner, etc.) TMCZ will inform the Customer if
5)
Direct debit from a bank card will be set up after T-Mobile receives an authorization form
such circumstances arise.
confirmed by the Subscriber. If you select the electronic Statement of Services, you cannot
use the postal order as the payment method.
Platné od 1. 7. 2013