I am the applicant whose name appears on this Application. I am the lessee/authorised person of the telephone line which I am applying for NBN to be connected on. I have read, understood and agree to be bound by Montimedia’s Standard Terms & Conditions. I understand Montimedia may exchange information with a credit reporting agency, to obtain a consumer credit report about me, and/or to allow the credit reporting agency to create/maintain a credit information file containing information about me. All the information I have provided in this Application is true and correct.

I agree to the potential charge of subsequent installation fee as outlined on NBN Co's website https://www.nbnco.com.au/develop-or-plan-with-the-nbn/new-developments/government-policy-for-new-developments.html (This charge comes from NBN Co and if you would receive it, it will be the same circumstance from every telco in Australia) - please call us on 1300 137 768 option 3 prior to form submission if you would like to discuss this.