Application Form
Application Form
Application Form
Request
Customer Information
Title: Name: Mobile No.: Mr. Mrs. Ms. ID Type: National ID Iqama CR Haj Card
Important information
You can use this form to add/ remove/upgrade or change your Zain mobile phone services. A change in address should be clearly mentioned to facilitate communication between Zain and you. In case you are sending this duly filled Application Form through an authorised individual, please remember to present his/her original ID or Iqama card too. Please refer to price list for change in options 2, 4, 5, 6, 7, 8, 9 &10. Changes requested may carry a nominal fee. Please ask our Zain representative for the price list and refer to it for details. For further inquiries please call 959 or fax us at 059 000 5959 or email us on cc@sa.zain.com 1 Normal suspension fee applies. 2 You might be billed for roaming usage for past period till today, on future invoices for the next 2 months, if any.
Passport
1. Mailing Address
P.O. Box: Other Address (e.g. Work):
Change
Postal Code:
Add
City: Region: Email:
5. Conversion of Service
Postpaid to Prepaid Prepaid to Postpaid (Application form required for new owner) Prepaid Package:
I do not wish to receive my bill from Zain. I will check it online I would like to receive a printed bill from Zain
6. Change Package
Current Package: New Package: Date of Change (DD/MM/YY):
Comments
8. Itemised Bill
From Date:
(DD/MM/YY)
To Date:
(DD/MM/YY)
9. Service Status
Suspension 1 Date (DD/MM/YY): Cause for termination: Reactivation Termination 2
Declaration
I, the undersigned, have read, understood and agreed to Zains terms and conditions as stated on the back of this form. I authorize Mr./Mrs./Ms.:
Holder of ID No.: ID. Type: To apply for the above changes on my behalf Name of authorized: Signature of authorized: Date (DD/MM/YY): Customer Name: Customer Signature: Employee Code: Shop Code: Dealer Code:
Service Application
P.O. Box 959 Riyadh 11421 Kingdom of Saudi Arabia
1. Request
New Subscription Change from Prepaid to Postpaid Transfer of ownership Change from Postpaid to Prepaid Mobile number portability
Important information
You can use this form to apply for Zain mobile phone service for personal use or for your friends/ family members. You can opt for the Zain Postpaid or Prepaid mobile phone service. Your ID Card must be provided along with the Application Form. In case you are sending this duly filled Application Form through an authorised individual, please remember to present his/her original ID or Iqama card too. For further inquiries please call 959 or fax us at 059 000 5959 or email us on cc@sa.zain.com 1 Money Deposit required for nonresidents. 2 International calls and Roaming services are subjected to guarantee conditions.
2. Applicant Information
Title: Name: Gender: Nationality: Male Female Date of Birth (DD/MM/YY): Profession: Mr. Mrs. Ms. ID Type: National ID Iqama CR Family Card ID No.: Passport Haj Card
3. Contact Information
Address: City: Home Tel.: Office Tel.: Ext.: Other Mobile: Email: Region: Fax:
4. Mailing Address
P.O. Box: Postal Code: P.O. Box City: Email Fax Region: I would like to receive my bill via
3 Money Deposit required for non-Saudi National. 4 Authorized person should hold copy of the power of attorney. 5 ID of customer and authorised person or identifier of application must be attached.
6. Transfer of Ownership (change request form required for the previous owner)
Previous Owners Name: Previous Owners Signature: ID No.: Date (DD/MM/YY):
Declaration
I, the undersigned, have read, understood, and agreed to Zains terms and conditions as stated on the back of this application and accept the credit limit assigned to me of SR__________. If the stated credit limit is exceeded, then Zain reserves the sole right to pursue a course of action which it deems appropriate. I am fully responsible to pay the entire invoice even if it exceeds this credit limit. Authorized Person I authorize Mr./Mrs./Ms. 4 Identifier (Relation: ...............................)
Prepaid
Device SN (IMEI): Commitment period: For Postpaid Only Additional Data Service: Additional Fax Number: International Calls: 2 International Roaming: 2 Preferred Language: Communication Language: Preferred Date Format: Directory Listing Service: Additional Services:
Yes Yes Yes Yes 3 Arabic Arabic Hijri Listed No No No No English English Gregorian Unlisted Hindi/Urdu
Holder of ID No.: 5 Mobile No.: to collect the mobile package on my behalf. Date (DD/MM/YY): Name of authorized / Identifier: Signature of authorized / Identifier: Date (DD/MM/YY): Customer Name: Yes Yes No No Customer Signature: Employee Code: Shop Code: Dealer Code:
8. Information Updates
I would like to receive information from Zain.
9. Itemised Bill