Type of Application:

New application Change of Plan

Please tick the appropriate box or complete the answer.

IMPORTANT: Please read the terms and conditions carefully. fill up the details, attach the supporting documents as required and e-mail to enquiry@pr1macomm.azurewebsites.net application must be made by pr1ma home’s owner or any authorised person (authorisation letter from the home owner is required).

Particulars of Applicant/Subscriber (“Customer”)

Name as per NRIC:

NRIC:

Installation Address:

City/Postcode:

State:

Office Tel No:

Mobile No:

Alternative No:

Product/Service Details

Type of Product/Service (Package prices are to be advised):

1. PR1MA Comm Residential Broadband Plan

2. VOIP Telephone Line

PR1MA Comm VoIP (Monthly Rental RM 10.00)

Date1

Time1

Date2

Time2

Date3

Time3

*While we exercise reasonable effort to meet your preferred date, there is no guarantee that we would be able to meet your request
*Voice call rate 0.20 per/min

Billing Information

Please tick if the address is the same as the address above.

Billing Address:

City

Postcode

billing Email

State

Billing

Email Itemised paper bill (RM 3/month)

Important Notes

I have read and agree to the Terms and Condition I have read and agree to the Important Notes

Particulars of Applicant/Subscriber (“Customer”)

Product/Service Details

Billing Information

Contact Information:

(Closed on public holidays)
Monday – Friday: 9.00AM – 6.00PM
Saturday: 9.00AM – 1.00PM

Quick Access:

© 2023 PR1MA COMM

Particulars of Applicant/Subscriber (“Customer”)

Product/Service Details

Billing Information

Contact Information:

(Closed on public holidays) Monday – Friday: 9.00AM – 6.00PM Saturday: 9.00AM – 1.00PM

Quick Access:

© 2023 PR1MA COMM

(Closed on public holidays)
Monday – Friday: 9.00AM – 6.00PM
Saturday: 9.00AM – 1.00PM