Globe Broadband and Wireline Loyalty Program

I,__________________________, have fully understood the mechanics, terms and conditions and warranties pertaining to Globe Broadband & Wireline Loyalty
Program (Program). Further, I understand and agree that the Program covers Account number _________________ which will be locked up or re-contracted
for a period of 24 months upon availment.

This Account number and Globe mobile number(s) specified above shall be bound by the terms and conditions of this Program. Should you request a change of
number it will also be bound by this Agreement.

Name:________________________________________________________________ Alternate Landline Number:__________________________________
Delivery Address:________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
Handset Model: ______________
Handset Base Price: __________________


Terms & Conditions:
I hereby commit myself to the following conditions upon availment of ________________ (Program Offer) for FREE:

a) My account is currently free from any past due balances.
b) My subscription enrolled under this Program will be locked up or re-contracted for the period stated above (Holding Period).
c) I shall not downgrade my plan or assign or transfer any rights or obligations of my subscription or terminate my line; Should l downgrade my plan or
transfer any rights or obligations or terminate my line within the Holding Period, the following fees will apply:
Full amount of current handset base price of the units I availed of if my plan is downgraded or transferred or terminated within the first 12
months of the Holding Period
50% of current handset base price of the units I availed of if my plan is downgraded or transferred or terminated within the 13
th
to 24
th
month of
the Holding Period
d) My current subscription enrolled under this Program shall not be further included in any other promotional activity that would entail additional minimum
subscription period (such as Extension Line Promotions, Handset upgrade programs) until expiration of the Holding Period of this Program.

Should my line get temporarily disconnected within the current Holding Period for a cumulative number of at least 30 days, I commit myself to the conditions stated
above for an additional period equivalent to the number of days my subscription was temporarily disconnected.

In addition to the foregoing, all other terms and conditions stated in the Application Form/Mobile Service Agreement which I have previously signed shall continue to be in
full force and effect.

I confirm that I have read and understood the Terms and Conditions stated in this document and I agree to comply with them. I understand that Globe reserves the right to
change the Terms & Conditions stated herein without prior notice.

Subscriber Signature: _____________________________ Date: ______________________________________

Handset Availed: ________________________________ Handset Base Price: __________________________

Mobile Number: __ Acct Number: ________________________________

==========================================================================================================================
Terms and conditions for handset replacement:

1. The subscriber has to submit the defective handset and the Material Document (i.e. the form which contains the handset model and IMEI number) which
subscriber signed upon receipt of the handset to any Globe Store within seven (7) calendar days from receipt of handset.
2. Globe Store will not accept any handset replacement beyond seven (7) calendar days from receipt of the handset. The subscriber needs to have the handset
repaired through any of the handset manufacturers service centers.


Authorization Form

If I am unable to accept the handset upon delivery, I authorize the bearer, Mr./Ms. _________________________________________________ with address at
__________________________________________________________________________________________, to receive on my behalf.
I understand that Globe reserves the right to withhold the handset in case of incomplete documentation or in the event that my representative fails to present or
establish valid identification.




_______________________________
Subscribers Name & Signature




__________________________________
Representatives Name & Signature
(Present ID with photo & signature)

Account Number:____________