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 ADSL to be connected on. I have read, understood and agree to be bound by Montimedia Internet’s Standard Terms & Conditions. I understand Montimedia Internet 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.