application form

iPhone 5 Plans
Serial No.:

Complete this form if you are applying for iPhone 5 Plan.

Contact No.: ............................................

Date: ..............................

Subscriber details
Full Name of Applicant Mr/Ms/Mrs:
P.O. Box:
ID Document Type:

Emirate:

Nationality:

Emirates ID

Passport

GCC ID

ID Document No.:

Date of Issuance (dd/mm/yyyy):

Date of Expiry (dd/mm/yyyy):

Visa No.:

Date of Issuance (dd/mm/yyyy):

Date of Expiry (dd/mm/yyyy):

Unified No. (required in case of Passport):

Residency File No.:

Date of Birth (dd/mm/yyyy):

Gender:

Male

Female

I would like to receive SMS updates about Etisalats promotions & offers:

Delegate details
ID Document Type:

No

Yes

Email:

Delegate Name:

Emirates ID

Power of Attorney
Passport

Unified No. (required in case of Passport):

1. iPhone 5 Plans

Date of Expiry (dd/mm/yyyy):

Residency File No.:

Date of Birth (dd/mm/yyyy):

Letter of Delegation

GCC ID

Date of Issuance (dd/mm/yyyy):

ID Document No.:

P.O. Box:

Working No.:

Gender:

Nationality:
Male

Female

Emirate:
Working No.:

New (Please fill Postpaid or Prepaid Service Application Form

Existing

Device Models

Device Colour

Package

16GB

Black

Prepaid Plan

32GB

White

Postpaid Data Plan

64GB

Postpaid no Contract Plan

Local minutes

Postpaid Contract Plan

International minutes

Business Plan 1
Business Plan 2

I/We agree to the attached Terms and Conditions of the iPhone Plan, I/We confirm that the above
information is accurate and I/We commit to advise Etisalat of any changes.
Customer: ...................................................................................................................................................................................................................................................................................................
Signature: ...................................................................................................................................................................................................................................................................................................
Signed by: ...................................................................................................................................................................................................................................................................................................
Nationality: ................................................................................................................................................................................................................................................................................................
Date: ..............................................................................................................................................................................................................................................................................................................

2. Documents required
Signed service contract

UAE National ID copy

Passport copy

Valid trade licence

3. For official use

New Account No.:

TM and 2013 Apple Inc. All rights reserved.

Power of attorney

4. Available subscription packages

Prepaid Plan

Data Plan

Non Contract Plan

Contract Plan

Upfront Charges 16GB

AED 2,749

Free

AED 2,749

Free

Free

Free

Upfront Charges 32GB

AED 3,149

Free

AED 3,149

AED 399

AED 399

AED 399

Upfront Charges 64GB

AED 3,549

Free

AED 3,549

AED 799

AED 799

AED 799

AED 99

AED 249 - 16GB

AED 279 - 32GB
AED 299 - 64GB

AED 225

AED 449

AED 349

AED 299

1GB

2GB

8GB

4GB

10GB

10GB

Monthly Rental

Data Capacity
Local or International
Voice Minutes

800 Local or
800 Local or
400 Local or
400 Local or
200 International 200 International 100 International 100 International

Local SMS
Contract Period

Business Plan1 Business Plan 2

No contract
3 months free*

18 months

200

200

100

100

No contract

12 months

18 months

24 months

*For the first three months the customers will benefit from 1GB/month for free, after three months the monthly package of 1GB will be charged at AED 99.

Terms & Conditions

Free connection will be provided for having the package on new GSM prepaid
and postpaid connection
Free SIM card replacement can be provided for having the package on existing
GSM connection
Out of bundle rate is 1 AED/1MB for all the packages
Contract period is 12 months from the package activation date for the
subscription to Contract Plan and 18 months from the package activation date
for the subscription to Data Plan.
Business Plan Contract period is 18months from the package activation date
for the subscription to Business Plan1 and 24 months from the package
activation date for the subscription to Business Plan2.
Device warranty period is 12 months from the activation date, charges may apply
Upon the expiry of the contracts term Etisalat will not suspend the service
and the same monthly rental will apply, with exception to the following plans
(1) Data Plan where the monthly rental will be AED 249 for 5GB (2) iPhone no
contract plan where the monthly rental will be AED 449 for 4GB, 200SMSs and
800 local minutes or 200 International minutes. The customer will have the
option to exit at any time following to the minimum commencement period
without paying any penalty or exit charges
Depending on the applicable plan customer will have the option to shift
between the bonuses packages of local or international minutes for any time
only once at each month, charges may apply
The minimum period of hire for this offer is contract period of 12 calendar
months for Contract Plan, 18 calendar months for Data Plan/Business Plan 1
and 24 months for Business Plan 2 commencing from the date of the service
provisioning, therefore, it is agreed that the customer subscribing to the
service, the discounted price for this offer is conditional upon the customers
commitment to keep his subscription activated for not less than the contract

period from the date of purchase of the phone, being the minimum hire period
In the event the customer terminates contract prior to this minimum period of
hire, an exit charge shall be paid by the customer to Etisalat
The duration of the minimum commitment period will be extended by any
periods of temporary service suspension. A temporary service suspension shall
include but is not limited to the customers failure to pay Etisalats charges
on time
Notwithstanding the reasons for premature disconnection or termination of
a service, if the customer terminates a service, the customer shall be liable to
pay the outstanding cost of the device on a pro rata basis for the remaining
term of the minimum hire period and any outstanding Etisalat charges at the
date of termination
The customer shall also be liable to pay the cost of the device on a pro
rata basis for the remaining term of the minimum contract period and any
outstanding Etisalat charges at the date of termination, if the service has
been disconnected by Etisalat due to the customers failure to settle any
outstanding amounts against the subscription; or due to the customers
delayed settlement beyond the credit period; or the service is ceased under a
court order; or the disconnection is due to the request of an official body; or
the service disconnection is due to any breach of these terms and conditions;
or violation of any of the applicable laws and regulations.
Contract Termination
No exit charges applicable on cancellation of Prepaid and Non Contract Plans
For all other plans, the subscribers will be charged remaining device
subsidy amount calculated on a pro rata basis. For the table charges details
please visit www.etisalat.ae/iphone