Application for Connect Messaging Services

Please fax the completed form to Xantic Customer Services:
Fax: / Via Customer Services in Australia: +61 7 5498 0098
Via Customer Services in Netherlands: +31 70 343 4796

For quality reasons please do complete this form in capital letters only

1. Name and address of prospective user of Xantic’s Connect Messaging Services:
Company name
Contact person
Address
Postal Code/ZIP Code
City
State

Country

Telephone number
Fax number
VAT number
(only for companies in the European Union registered for VAT)
Please confirm my registration via*:
E-mail - address:
Fax - faxnumber:

* please check the appropriate box

2 A: New Registrations / 2 B: Existing Users
MailConnect
à go to MailConnect registration, section 3
WebConnect
à go to WebConnect registration, section 4
TelexConnect
à go to TelexConnect registration, section 5 / I currently use:
MailConnect
WebConnect
TelexConnect
Other, please state:
This concerns a
Change request
Cancellation/Deletion

Please make sure you enter all fields and data required. If information is missing this might cause a delay in processing your registration.

3. MailConnect registration
The Xantic MailConnect Service is available for worldwide communications between Internet e-mail accounts and Inmarsat terminals. Users of MailConnect need to be registered before being able to communicate to Inmarsat terminals.
E-mail addresses that you will send your messages from.
Please provide only INTERNET e-mail address(es).
1 / @
2 / @
3 / @
4 / @
5 / @
6 / @
7 / @
8 / @
9 / @
10 / @

à Please continue with section 6

4. WebConnect registration
The Xantic WebConnect Service is available for worldwide communications between an Internet Webbrowser and Inmarsat terminals. Users of the WebConnect Webbrowser need a prior registration before being able to communicate to Inmarsat terminals. For the WebConnect registration no specific user information is required.
à Please continue with section 6
5. TelexConnect registration
Telexmachine you will use this service from:
Telexnumber: / Answerback:
Telexnumber where delivery notifications should be sent to:
Telexnumber:
Additional information for customers who use a REFILER
Refiler name: / Identification string:

à Please continue with section 6

6. Payment
The Xantic Connect Messaging Services require a direct billing relationship with Xantic. For new customers, Xantic reserves the right to perform a preliminary financial check. Each month the registered customer will receive a specified bill. Customers will only have access to those services for which they are registered.
6 A - New Registrations
To whom and which address should the bills be sent? / Same as in question 1
To a different address (please provide details below)
Company name
Contact person
Address
Postal Code/ZIP Code
City
State
Country
6 B - Existing Users (please indicate if a separate account should be opened for this registration)
Add this registration to my existing account
Account number
Open separate account for this registration
To whom and which address should the bills be sent? / Same as in question 1
To a different address (please provide details below)
Company name
Contact person
Address
Postal Code/ZIP Code
City
State
Country
7. Acceptance
The contracting party agrees to these conditions and tariffs applicable to Inmarsat services.
For more information on conditions and tariffs call Xantic Customer Services, Tel.: +31 70 343 4543 (The Netherlands) or +61 7 5498 0000 (Australia).
Name contracting party or assignee: / City: / Date: / Signature:
Remarks Xantic Sales:
For more information visit our website www.xantic.net or email to
Access via the Netherlands
Tel: +31 70 343 4543
Fax: +31 70 343 4796 / Access via Australia
Tel : +61 7 5498 0000
Fax: +61 7 5498 0098
Telex: (71) 22432 TELCSC AA

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