Saco Technology

Simply complete the Broadband application form below

Agent (Optional)

Promo Code (Optional)

First Name

Last Name

Date of Birth - DD/MM/YYYY

Business Name (Optional)

Address

Suburb

State

Post Code

Phone Number

Fax Number

Mobile Number

Email Address

Please enter your desired username and password below. These details will be used to allow you to connect to the internet.

Username

Password

Connection Type

Modem Type

Broadband Plan

Landline Number for the Broadband

If you have selected a bundled broadband plan above please remember to also complete a landline application form as well

Extras (Optional)

No Shapping - Extra $10 per GB

Static IP - $4.95 a month

512/512 Plan at 1500/256 Pricing

How did you hear about Saco Technology?

How would you prefer to be notified about the progress of your application? ?

Please complete the payment details below selecting either credit card or direct debt as your preferred payment option

Your selected payment method will be charged the connection/transfer fee on completion of this application form

Payment Method

Mastercard

Visa

Direct Debit

Name on Card

Card Number

Expiry Date - MM/YY

Please complete the details below if you selected direct debt as your payment option above

Account Name

BSB

Account Number

I authorise and request the debit user detailed below to debit payments from my nominated account, as specified below, at intervals and amounts as directed by Saco Technology as per the Terms and Conditions of the Saco Technology agreement and subsequent agreements. I/We authorise Saco Technology to debit my/our account at the Financial Institution identified above through
the Bulk Electronic Clearing System (BECS) in accordance to the Payment Details stated above or detailed in separate agreement and as per the Terms and Conditions provided. The administration of this agreement is conducted by Saco Technology and its third parties. The services provided by Saco Technology are administrative to the status of the Agreement and do not extend to the provision of any services or benefits of the Agreement as provided by the Business. This authority shall be interpreted and enforced pursuant to the laws of the state of Queensland. The Financial Institution may, in its absolute discretion, determine the order of priority of payments by it of any monies pursuant to this request or any other authority or mandate. Saco Technology or its third parties will provide 14 days notice if the payment amount (s) of frequency of the payments vary for future debits. It is your responsibility to ensure that you have sufficient clear funds in your nominated account to enable the direct debit to be honoured by your financial institution. Direct debits normally occur overnight; however transactions can take up to three (3) days depending on your financial institution. If your Debit request falls on a weekend or public holiday, it will be processed on the next working day. You are advised to verify account details against a recent bank statement and if uncertain you should contact your financial institution. If your Direct Debit is dishonoured or returned by your financial institution, for any reason, Saco Technology reserves the right to charge a dishonour fee, and re-present the Direct Debit for processing again on the next business day. Any dispute arising from this or subsequent direct debits are to be directed to Saco Technology on 1300 664 186 or in writing to the address provided above, or you may contact your financial institution If no resolution is forthcoming you are advised to contact your financial institution. If you lodge a DDR Customer Claim form with your financial institution they will investigate whether the transaction was authorised by you. If the transaction date was no earlier than 12 months from the date of your claim you should receive a response within 7 days from the date of your claim. If the transaction date was made earlier than 12 months from the date of your claim you should receive a response within 30 days from the date of your claim. We will keep your information about your nominated account at the financial institution private and confidential unless this information is required to investigate a claim made in relation to an alleged incorrect or wrongful debt, or otherwise required by law. You may stop, cancel , alter or defer your Direct Debit Request at any time, by contacting your Financial Institution or by providing at least 14 Business Days written notification to Saco Technology at the address detailed below. I/We authorise the Debit User to verify the details of the abovementioned account with my/our Financial Institution. I/We authorise the Financial Institution to release information allowing the Debit User to verify the abovementioned account details. I/We agree to accept payment notifications from the business by either E-mail or SMS as determined by the business. If I do not wish to receive such notifications I will contact the business directly so as to be omitted from such notifications.

I/We understand: the ADSL plan and hardware option I/we have selected; prices quoted are for self installation with telephone support; a minimum of 5 working days is required for service connection to be completed (unless otherwise notified) and that connection time also depends on port availability at the exchange; each ADSL account is only for use at the premises as indicated on this application and that each account is not transportable unless moving premises; all services provided by Saco Technology must be paid for in advance except by written agreement with Saco Technology management. If an account is not in credit the account may be disconnected at the discretion of Saco Technology; all accounts must be paid by Credit Card or Direct Debit except where there is prior written agreement with Saco Technology Management; Saco Technology will always aim to provide the best and most reliable service possible, but cannot be responsible for any loss of service, regardless of the party at fault; the account will not be used for any illegal or anti-social purposes, including obscene, abusive, fraudulent, threatening or otherwise unacceptable messages or usage; in the event that my/our account remains unpaid for a period of 30 days or more, Saco Technology reserves the right to disconnect my/our service. Fees which result from the reactivation of the service will by my/our responsibility; if applying for phone service with Saco Technology I authorise Saco Technology to act on my behalf to transfer my phone service to Saco Technology for all phone charges. I also understand that any changes made to contact or payment details on this form will be updated in Saco Technology�s system unless stated otherwise; I am aware that Saco Technology will only begin charging me for the service once the line has been transferred and my current provider will charge me for the service up to this time. I understand that it is my responsibility to check the terms and conditions of my current telephone provider/s in relation to the services being transferred to Saco Technology; bundling customers please note that bundling criteria apply, see ADSL terms and conditions; I/we have read and understood Saco Technology�s General Terms & Conditions, Saco Technology ADSL Terms & Conditions and Saco Technology�s Phone Terms & Conditions (found on our Web Site or provided to me/us by a Saco Technology representative at my/our request) and agree to abide by them. I/we also verify being over the age of 18 and agree that if our broadband (ADSL) service is moved, discounted o churned within the first 6 months that we will be required to pay a termination fee of $129.95.

Full Name

Initials

Date - DD/MM/YY

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