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Personal Application form - Monthly plans Mobile number *du shop ID *Sales Advisor ID/Dealer ID *Dealer stamp 05 (if applicable) Customer information *Title *First name Middle name *Family name *ID type: Passport *ID/Passport number *ID/Passport issue date Emirates ID *ID/Passport expiry date / / *Nationality DD MM YYYY *Visa type *Visa number / / DD MM YYYY U.I.D. number *Gender: Male *Date of birth Female / / DD MM YYYY *Alternative contact number *Visa expiry date / / DD MM YYYY *Email Documents submitted Utility bill, fixed line, DEWA, etc. (valid within the last 3 months) Salary certificate, minimum AED 2,500 (Elite 750 minimum AED 15,000) Current tenancy/ownership contract (showing physical address) Copy of a platinum credit card or equivalent (Elite 750 only) Pay slip (signed, stamped and valid within the last 30 days) Credit card (must be valid and issued in the UAE) Security deposit AED 1,500 (du shops/Homephone Plus only) Home address *Building/villa *Street *Unit number *P.O. Box *City *Emirate Billing information (required if different from home address) Building/villa Street Unit number P.O. Box City Emirate Auto payment by credit card: Yes Bill delivery: Email only *Bill/correspondence language: English No Mail and email Arabic Auto payment by credit card Type of credit card Visa MasterCard Credit card number Plan selection Expiry date / / DD MM YYYY Elite Plans BlackBerry Bundles Data Bundles Multi SIM Elite Plan: Emirati Plans: 100 Social 40 MB Number of additional SIMs (Max. 4) 250 100 MB National 100 MB Elite Super Plans: 100 500 1 GB National 1 GB 250 4 GB National 4 GB Other plans 500 Monthly Data Plan: 25 GB National 25 GB 750 International Contract details for Number Privilege Plan *Monthly minimum usage with: Gold AED 750 Silver AED 500 Bronze AED 250 Special AED 100 AP-MPE-NPP-NOV12 Smartphone and Devices Offer Smartphone Privilege Offer AED 200 Upfront fee AED Charge to my credit card Monthly plan and NPP Forms A4.indd 1 11/22/12 4:49 PM
