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Consumer Application Form

ORIGINAL2018/11/27 Page 1 Consumer Application FormAgent to complete:Apply forNew applicationChange of ownershipPortingService requiredFixedMobileUpsellAgent name Campaign nameOrder customer ID Supporting documentation (new customer) Proof of identification: Copy of SA ID or passport (including work permit) Copy of your most recent payslip and three months bank statements Copy of proof of residence (utility bill not older than three months) For porting purposes, account number at donor/existing service provider requiredSupporting documentation(existing fixed/mobile customer) Proof of identification: Copy of SA ID or passport (including work permit)Sections to completeNew applicationSections: 1, 2, 3, 5A or 5B, 6 Change of ownership Sections: 1, 2, 3, 4, 5A, 5B, 6 Porting Sections: 1, 2, 3, 5C, 6 UpsellSections: 1, 2, 3, 5A, 5B, 61. Customer detailsAre you an existing customer?

Telkom SA SOC Ltd is an authorised Financial Services Provider, FSP number: 46037, underwritten by Mutual & Federal Risk Finance Ltd, a member of the Old Mutual Group. I/We have purchased the Telkom Cellular Insurance and …

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