Relocation Form

1. Subscriber Information

Select Title :	-- select-- Mr. Ms. Mrs. Miss
First Name:
Last Name:
Konnectv ID :
2. Contact Information
Telephone number (Home) :
Telephone number (Office) :
Fax:
Mobile:
Email id:
3. Relocation From(Old Address)
Address:
Suburb:
State:
Postcode:
Installation Type: Roof / Wall / Pot Plant
4. Relocation To (New Address)
Address:
Suburb:
State:
Postcode:
Property Type:	-- select-- Apartment Townhouse / Rented house Own House
	Pot Plant Indemnity Realignment Indemnity Strata Permission
Pot Plant Indemnity Form Konnectv is a Pay TV Service Provider providing Indian Channels in Australia. To receive the service a 75 cms KU Band satellite dish is required. Pot Plant Installation details: 75 cms dish is fixed in a planter with pole in concrete/fixed on a concrete slab. No holes are drilled in the property. The cable runs freely from the dish in the balcony/courtyard to the TV. Total weight of the equipment is 40 kgs. Subscriber's Undertaking Title : -- select-- Mr. Ms. Mrs. Miss First Name : Last Name : Address : Suburb : State : Post Code : Contact Information Tel (Home) : Tel (Work) : Mobile : Email : I take full responsibility for installing a pot plant dish at the above mentioned address. I understand that I am responsible for obtaining permission from the authorised person/agent to install the dish. I agree to pay for the removal of the dish if I am asked to remove it at any time. I take responsibility for any damage that may arise from the equipment to any person or property. I will bear the service call charge in case of any signal problem with the service. Also, if at the time of installation there is no signal, I will bear the service charges as mentioned in the Konnectv Rate Card. Subscriber Name : Date: Realignment Indemnity Form Konnectv is a Pay TV Service Provider providing Indian Channels in Australia. To receive the service a 75 cms KU Band satellite dish, a decoder and Smartcard is required. Subscriber's Undertaking Title : -- select-- Mr. Mrs. Miss First Name : Last Name : Address : Suburb : State : Post Code : Contact Information Tel (Home) : Tel (Work) : Mobile : Email : I take full responsibility for equipment installed at the above mentioned address. I understand that I have got the equipment installed by my own private installer . I take responsibility for any damage that may arise from the equipment to any person or property. In case of any signal problems with the service, I agree to get it fixed myself and bear the charges. I agree to return the Decoder and Smartcard / Smartcard to Konnectv when I disconnect Konnectv subscription. Subscriber Name : Date : Strata Permission Form Konnectv is a Pay TV Service Provider providing Indian Channels in Australia. To receive the service a 75 cms KU Band satellite dish is required. Pot Plant Installation details: 75 cms dish is fixed in a planter with pole in concrete/fixed on a concrete slab. No holes are drilled in the property. The cable runs freely from the dish in the balcony/courtyard to the TV. Total weight of the equipment is 40 kgs. Strata Management Approval Tennant / Owner Name : Address where permission : is given to install the dish   Suburb : State : Post Code : Tel (Home) : Approval has been given to install the dish on : Roof Wall Pot Plant Approving Authority Name : Strata / Real Estate Name: Contact No. : Date :
Storey :
No. of Storey :
Installation Type: Roof / Wall / Pot Plant
I authorize Konnectv to debit my account for Relocation/Reinstallation service provided. Charges as per the Konnectv rate card will be applicable. If any extra equipment is used for relocation, the charges as per the Konnectv rate card will be applicale. To Know more details click here I take responsibility for installation of equipment at my premises to more details... to more details... click here
I have taken permission from the relevent authority/ do not required permission. How would you like to receive confirmation? Email Post Fax
I accept terms & conditions
Subscriber signature :     Date :