Customer Information Form (Page 2 of 2) in pdf

Customer Information Form Page 2

*Service Provider :

China Mobile Hong Kong Company Limited

(CCSS is limited to the listed

China Unicom (Hong Kong) Operations Limited

service providers participated

China-Hong Kong Telecom Limited

in the scheme)

CITIC Telecom International Limited

CMMobile Global Communications Limited

CSL Mobile Limited

Hong Kong Broadband Network Limited

Hong Kong Telecommunications (HKT) Limited

Hutchison Global Communications Limited

Hutchison Telephone Company Limited

i-CABLE

IMC Networks Limited

Multibyte Info Technology Limited

New World Telecommunications Limited

SmarTone Mobile Communications Limited

Sun Mobile Limited

Wharf T&T Limited

*Referral Number Provided by the

Service Provider

*Description of the Complaint :

(Applicable to billing

dispute only, please use

separate sheet if needed)

*Disputed Amount :

HK$

(Applicable to HK$300 or above)

Date of Occurrence of Dispute :

Date of First Complaint to the

Service Provider :

Note:

*Mandatory field. Your application may be rejected if the required information is not

provided.

Please contact your service provider to obtain the Referral Number.

Customer Information Form Page 2