Payment Agreement Request Back Payment Agreement Request Here is your convenient online application Account Information Are you the account owner - Select -YesNo Account Number Account First Name Account Last Name Country Code - Select -Guyana +592Afghanistan + 93Albania + 355Algeria + 213American Samoa + 1-684Andorra + 376Angola + 244Anguilla + 1-264Antarctica + 672Antigua and Barbuda 1-268Argentina + 54Armenia + 374Aruba + 297Australia + 61Austria + 43Azerbaijan + 994Bahamas + 1-242Bahrain + 973Bangladesh + 880Barbados + 1-246Belarus + 375Belgium + 32Belize + 501Benin + 229Bermuda + 1-441Bhutan + 975Bolivia + 591Bosnia and Herzegovina + 387Botswana + 267Brazil + 55British Indian Ocean Territory + 246British Virgin Islands + 1-284Brunei + 673Bulgaria + 359Burkina Faso + 226Burundi + 257Cambodia + 855Cameroon + 237Canada + 1Cape Verde + 238Cayman Islands + 1-345Central African Republic + 236Chad + 235 Chile + 56China + 86Christmas Island + 61Cocos Islands + 61Colombia + 57Comoros + 269Cook Islands + 682Costa Rica + 506Croatia + 385Cuba + 53Curacao + 599Cyprus + 357Czech Republic + 420Democratic Republic of the Congo + 243Denmark + 45Djibouti + 253Dominica + 1-767Dominican Republic + 1-809East Timor + 670Ecuador + 593Egypt + 20El Salvador + 503Equatorial Guinea + 240Eritrea + 291Estonia + 372Ethiopia + 251Falkland Islands + 500Faroe Islands + 298Fiji + 679Finland + 358France + 33French Polynesia + 689Gabon + 241Gambia + 220Georgia + 995Germany + 49Ghana + 233Gibraltar + 350Greece + 30Greenland + 299Grenada + 1-473Guam + 1-671Guatemala + 502Guernsey + 44-1481Guinea + 224Guinea-Bissau + 245Guyana + 592Haiti + 509Honduras + 504Hong Kong + 852Hungary + 36Iceland + 354India + 91Indonesia + 62Iran + 98 Iraq + 964Ireland + 353Isle of Man + 44-1624Israel + 972Italy + 39Ivory Coast + 225Jamaica + 1-876Japan + 81Jersey + 44-1534Jordan + 962Kazakhstan + 7Kenya + 254Kiribati + 686Kosovo + 383Kuwait + 965Kyrgyzstan + 996Laos + 856Latvia + 371Lebanon + 961Lesotho + 266Liberia + 231Libya + 218Liechtenstein + 423Lithuania + 370Luxembourg + 352Macau + 853Macedonia + 389Madagascar + 261Malawi + 265Malaysia + 60Maldives + 960Mali + 223Malta + 356Marshall Islands + 692Mauritania + 222Mauritius + 230Mayotte + 262Mexico + 52Micronesia + 691Moldova + 373Monaco + 377Mongolia + 976Montenegro + 382Montserrat + 1-664Morocco + 212Mozambique + 258Myanmar + 95Namibia + 264Nauru + 674Nepal + 977Netherlands + 31Netherlands Antilles + 599New Caledonia + 687New Zealand + 64Nicaragua + 505Niger + 227Nigeria + 234Niue + 683North Korea + 850Northern Mariana Islands + 1-670Norway + 47Oman + 968Pakistan + 92Palau + 680Palestine + 970Panama + 507Papua New Guinea + 675Paraguay + 595Peru + 51Philippines + 63Pitcairn + 64Poland + 48Portugal + 351Puerto Rico + 1-787Qatar + 974Republic of the Congo + 242Reunion + 262Romania + 40Russia + 7Rwanda + 250Saint Barthelemy + 590Saint Helena + 290Saint Kitts and Nevis + 1-869Saint Lucia + 1-758Saint Martin + 590Saint Pierre and Miquelon + 508Saint Vincent and the Grenadines + 1-784Samoa + 685San Marino + 378Sao Tome and Principe + 239Saudi Arabia + 966Senegal + 221Serbia + 381Seychelles + 248Sierra Leone + 232Singapore + 65Saint Maarten + 1-721Slovakia + 421Slovenia + 386Solomon Islands + 677Somalia + 252South Africa + 27South Korea + 82South Sudan + 211Spain + 34Sri Lanka + 94Sudan + 249Suriname + 597Svalbard and Jan Mayen + 47Swaziland + 268Sweden + 46Switzerland + 41Syria + 963Taiwan + 88Tajikistan + 992Tanzania + 255Thailand + 66Togo + 228Tokelau + 690Tonga + 676Trinidad and Tobago + 1-868Tunisia + 216Turkey + 90Turkmenistan + 993Turks and Caicos Islands + 1-649Tuvalu + 688U.S. Virgin Islands + 1-340Uganda + 256Ukraine + 380United Arab Emirates + 971United Kingdom + 44United States + 1Uruguay + 598Uzbekistan + 998Vanuatu + 678Vatican + 379Venezuela + 58Vietnam + 84Wallis and Futuna + 681Western Sahara + 212Yemen + 967Zambia + 260Zimbabwe + 263 Account Phone Number Mobile Contact Number Email Address Confirm email Product Type - Select -DSLFibreLandlineMobileLTEWireless VoiceWireless Voice & Data ID Type ID Type - Select -Driver's LicensePassportNational_idOther… Enter other… Documents Additional Documents One file only.10 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, pdf, doc, docx. Authorized Contact's ID One file only.10 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, pdf, doc, docx. Account Owner's ID One file only.10 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, pdf, doc, docx. Payment Terms Outstanding Amount Initial Payment (1/3 of O/standing Bal) Receipt/MMG Reference # Number of Monthly Payments - Select -123 First Payment Date Second Payment Date Third Payment Date Payment Terms I hereby understand and agree that in order for me to retain my One Communications service and before the approval of my payment request by One Communications, I shall make a payment equivalent to one-third of the sum due and owing to One Communications by me. Once such payment is made and subsequently my payment request is approved by One Communications, I hereby agree to make payments in the amount stipulated by me hereof in addition to the current monthly charges for my One Communications service on or before the 10th day of each month. Moreover, I understand and agree that failure to make the previously mentioned payments to One Communications on the stipulated dates will result in my One Communications service being disconnected forthwith and without any notice to me, at which time the entire outstanding amount shall become due and payable by me to One Communications.