V4 APPOINTMENT OF ADVOCATE OR AUTHORIZED REPRESENTATIVE

 

If you wish to appoint an Advocate or Authorized Representative to deal with us on your behalf, please read the following information carefully and complete the form accurately.

 

It is a requirement that this Appointment is submitted by post as a signed original, and is signed in the presence of, and witnessed by a registered Justice of the Peace, or alternatively, signed in the presence of and witnessed by a registered Lawyer, Doctor, Pharmacist, Police Officer or Center link Officer. This requirement is for your benefit, to protect your privacy and security and to minimize the risk of fraud.

 

V4 Telecom also accepts Power of Attorney and/or Guardianship Order as Advocate or Authorized Representative for a customer. Please forward a certified copy of the Power of Attorney or Guardianship Order together with this form, signed by the Attorney or Guardian or the customer.

 

What is an Advocate?

 

An Advocate is someone who may deal with us on your behalf. This includes making a complaint. An Advocate cannot make changes to your account or services and/or may not act on your behalf or access your information unless you are present and agree.

 

What is an Authorized Representative?

 

An Authorized Representative is someone who may deal with us on your behalf as your agent. This includes making a complaint. If you specify limitations, they have only those rights specified, on access to your information. If you do not specify limitations, they have power to act and access information as if they are you.

SECTION 1 - APPOINTMENT DETAILS


SECTION 2 - WITNESS STATEMENT

I hereby confirm that the person signing the above has produced evidence of their identity.

To view V4’s Terms of Business please go to our website or visit www.v4.net.au/tob directly.