New Zealand OTT Limited 121 Carbine Road, Mt Wellington Auckland 1060, New Zealand : 09 399 8058 : [email protected] Please fill the form & send it back to [email protected] OR Application Form & Contract post to PO Box 132328, Sylvia Park, Auckland 1644 TVB Anywhere in New Zealand 新西蘭�TVB�Anywhere�訂閱服務申請表及合約

Applicant Details 申請人資料

Surname 姓:…………………… First Name 名:……………………………………………………………….. Date of Birth 出生日期 dd/mm/yyyy: |__|__|/|__|__|/|__|__|__|__|

Contact Information 申請人聯络方式 Address 地址: ……………………………………………………………………………………………………………………………………..…… 地區 城市 郵政編碼 Suburb : ………………………………………….. City : ……………………………... Postal Code: : |__|__|__|__| Phone 電話: |__|__| |__|__|__|__|__|__|__| Mobile 手機: |__|__|__| |__|__|__|__|__|__|__|__|__|__| Email 電郵: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

Place where the OTT Box is installed 服務安裝地址及電話

Same as the above contact address  Yes (skip to next section) No (please fill in) Address 地址: …………………………………………………………………………………………………………………………………

Suburb 地區: ………………………….. City 城市:… Postal Code 郵政編碼: |__|__|__|__| Phone 電話: |__|__|__| |__|__|__|__|__|__|__|__|

Enable us to serve you better, can you tell us what is your native language: 主要語言 Spoken 口語:  Cantonese 粵 語  Mandarin 普通話  English Written書寫:  简体中文  繁體中文  English

親屬姓名 關係 Next of Kin ………………………Relationship : ……………………………… Optional: Referred by TVB Anywhere Subscriber Phone電話: |__|__|__| |__|__|__|__|__|__|__|__|__|__|__| Account No.用戶號碼: …………………………………… Address地址:…………………………………………..……………………………………………….… Account Name用戶姓名…….…………..….…………..

Services/Packages to subscribe 訂閱服務 Number of boxes to subscribe 訂閱機頂盒數量 : |__|__| NZ Pack TV Box: NZD68 (incl GST) per month for each box. Please refer to Channel listing overleaf. 新西蘭至尊組合 : 每台機頂盒租金每月費用為 NZD68(含稅) 。頻道內容詳情請參照背頁。

Payment Method 繳費方式：  One-off payment (10% discount plus 1 month free for 1-year contract, 2 months free for 2-year contract)  Monthly Payment: please select :  Auto pay  Electronic /Online Banking  Direct Debit Terms & Conditions to New Customer (More Overleaf) 重要條款適用於新客戶 (更多條款請參照背頁) :  Option 1 New Customers have to pay $100 bond to New Zealand OTT Ltd (herein after named as NZOTT) to enter a minimum 3- month subscription. The bond can only be refunded when customers return the OTT box in good condition & original package. It they fail to fulfil the minimum subscription, the bond will not be refunded. 新客戶訂閱期最少為三個月，客戶須付 100 元予 NZOTT 作 保証金。 3 個月期滿，並歸還完整無缺的 OTT 盒子給NZOTT 後客戶才可以獲退回此 100 元保証金。

 Option 2 New Customers have 1-year agreement with NZOTT. 須與 NZOTT簽訂為期一年的訂閱合約  Option 3 New Customers have 2-year agreement with NZOTT. 須與 NZOTT簽訂為期兩年的訂閱合約 The $100 deposit is being wavied for Option 2 &3. If they withdraw or breach the agreement within 1 year, they have to pay the unfulfilled subscription fee to NZOTT. The OTT box should be returned on terminating or cancellation of this agreement. 選擇選項 2或3的新