Device Information / Activation Date
Handset Name / Contact Number
Sales Price / Member Information
Membership Information / Member Name
Terms / Description / Member’s Initial / Member Address
Contract Term / City / State / zip
Activation Fee / E-Mail
Promotion / Date of Birth / SS#
Monthly Membership / Home# / Other#
Plan Name / Port-in Information
Monthly Due (MRC) / Current Mobile#
Included Minutes / Previous Carrier
Optional Features / Other Options / Previous Carrier Account #
Feature Name / Cost/Mo. / Member’s Initial / Account Password/PIN
$ / Port Request / Yes No
$ / Deposit / Yes No / Deposit Amount
______Customer Agrees to terms and conditions (하기 사항을 읽었으며 동의합니다.)
______Deposit CollectedCREDIT CHECK CONSENT AND REPORTING AUTHORIZATION – I authorize any person, or consumer or credit reporting agency to provide UBI Telecom with any information it has on me or the entity on whose behalf I make this application. I authorize UBI Telecom to: (a) compile this information, (b) disclose my account information, including any payment history and confidential information to credit reporting agencies or private credit reporting associations, and (c) periodically obtain and use my credit report and other credit information from any source in connection with UBI Telecom’s offering of wireless and other services. I understand that if I fail to fulfill the terms of my credit obligations under this Agreement, UBI Telecom may report my failure to a credit reporting agency.
GUARANTY– If I am signing on behalf of an entity, I agree to be jointly responsible with the entity for payments of any sums that become due under this agreement. I agree you can collect directly from me without first proceeding against the entity.
EARLY TERMINATION FEE – An Early Termination Fee of up to $225 per line of service may be assessed against you in the event that you terminate this contract before the expiration of its term.
Free call to Korea(한국 무료 국제 통화)– 한국 무료 국제 통화는 계약된 Free minute 이내에서 적용됨을 확인 합니다. (Night and weekend에 한국 국제 통화 시에도 계약된 Free minute에서 통화한 분 수 만큼 차감됨을 설명 듣고 확인 하였습니다.)
UBI Telecom Return Policy. –To cancel your contract, you are requires to return of your complete, undamaged UBI Telecom wireless device with the original retailer's proof of purchase within fourteen (14) days of purchase. You must still pay all charges based on actual usage (partial monthly service charges, taxes and UBIT surcharges). You will first need to contact UBI Telecom’s customer support center, and acquire a return authorization number (“RA#”). Should you cancel your service contract within fourteen (14) calendar days of your service activation, you will not be assessed an early termination penalty, provided that you return the UBI Telecom wireless device to the specified location, within fourteen (14) calendar days after obtaining the RA#. Please note: If you purchase any UBIT wireless device and/or accessory at a non-UBIT store (e.g. retail store), all returns must and shall be handled by the retail store, and not UBIT. Therefore, the retail store’s return policy shall apply, and may vary from store to store.
I ACKNOWLEDGE I AM AT LEAST 18 YEARS OLD, THAT I HAVE READ AND UNDERSTAND THIS AGREEMENT INCLUDING ALL CONTRACT PROVISIONS (INCLUDING THE TERMS OF SERVICE I WAS PROVIDED, ADDITIONAL COPIES BEING AVAILABLE FROM MY UBI TELECOM SALES REPRESENTATIVE OR ONLINE AT( I AGREE TO BE BOUND THEREBY. If signing on behalf of an entity, I represent that I am a duly authorized representative of the entity shown under “Billing Name”, and I have submitted this application in the capacity indicated as my “Title” thereunder. I am representing a corporation; I acknowledge that the execution of this agreement has been authorized by all necessary corporate actions.
Customer Signature / Dealer Signature