T-VoIP+V5T100Name* First Last Address* Street Address City ZIP / Postal Code Contact no.*E-mail* Document type* Swiss ID card Swiss passport Legitimacy card Working permit B Working permit C Working permit LDocument number*Nationality*Initiation*I would like a new Internet connection: As soon as possible Date: (this can take 10 to 20 days)I would like to switch to Telesonique* I move from following provider:to Telesonique on the (date):* Tariff plan*DSL-30/6 Mbits/s for 59.- Fr./monthDSL-60/12 Mbits/s for 69.- Fr./monthDSL-100/20 Mbits/s for 79.- Fr./monthDSL-250/50 Mbits/s for 89.- Fr./monthDSL-500/100 Mbits/s for 119.- Fr./monthFiber-30/6 Mbits/s for 59.- Fr./monthFiber-60/12 Mbits/s for 69.- Fr./monthFiber-100/20 Mbits/s for 79.- Fr./monthFiber-250/250 Mbits/s for 89.- Fr./monthFiber-500/500 Mbits/s for 99.- Fr./monthFiber-1000/1000 Mbits/s for 119.- Fr./monthMobile contract referenceNumber:(1) Discount does not apply to Voice customers if the line is not usedInternet connection or OTO number(1) (just for fiber) (excl. Surf 2 and Surf 5)Telephone number to connect:*(1) You can find the OTO number on your socket.The actual speed depends on your line (e.g. on the distance to the nearest telephone switchboard). In case of a cancellation the modem has to be returned. Otherwise a fee of 99 Fr. (respectively Surf 2 and Surf 5: 50 Fr.) will be charged. The contract has to be cancelled 30 days before it ends. In case the contract is cancelled before the mininum contract duration, the remaining monthly subscription fees shall be paid at once. One-time activation fee: 99 Fr. (respectively Surf 2 and Surf 5: 49 Fr.).Billing: Prices shown are in CHF incl. VAT. Only for normal, private use. In case an electrician is required, all costs shall be incurred by the customer. The delivery of an invoice by post is chargeable, 3 Fr. per invoice will be charged. The postal charges for cash payments at the post office will be charged later. Prices subject to change.With my signature I confirm that I have received, understood and accept the charges for this offer. I confirm that I am not under guardianship and that I am in full capacity to enter into this contract. I confirm that I understand and agree to the Terms and Conditions of TalkTalk Ltd., and I confirm that I have supplied the correct and full personal information.