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Existing PLDT Landline No.

eg. 2 (area code) 9989999 (landline #)

Last Name

eg. Cruz

First Name

eg. Juan

Middle Name

eg. Rizal

Mobile Number

eg. 09XXXXXXXXX

Email Address

eg. name@email.com

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I confirm that I have read, understood and agree to the provisions stated in PLDT Home’s Subscriber Certificate.

I agree and have read the Terms and Conditions for registered online customer regarding how PLDT will process personal data.