Documentation Process: Fido

REQUIRED Steps to Complete Your Service Request

1 2 3 4
Fill out this Affidavit, being sure to sign the document Attach Photocopy of Valid ID (See Examples of Valid IDs below)

Instructions

Attach Photocopy of Valid Ownership Document (See examples of Valid Ownership Documents below) Sign the Affidavit and Fax Documents to 1-866-546-0332 Once your service request is ready for completion or to check the status of your service request, please visit phoneclaim.com/fido

Where can I find my ESN/MEID/IMEI? On the original box OR Most Models iPhone
Under the battery on the back of your phone Check your receipt from the purchase of the device Your account at your carriers website
- Open iTunes 9.1 (or higher) - If Mac OS X - Choose iTunes > Preferences - If Windows - Choose Edit > Preferences - Click the Devices tab - Position the mouse over a backup device to display IMEI

Examples of Valid Personal Identification The following types of personal identification with photo will be considered valid forms for this process:
Drivers license (Canadian or International) Federal Firearms ID card Canadian Armed Forces ID card Government issued photo ID card (Federal or Provincial) Canadian or Foreign passport Municipal, Provincial or Federal Police Force ID

Important Reminders:

The name on the Photo ID must match the name of the account holder or the name of an authorized user who is over the age of 19. If the name does not match, then additional documentation may be required. Increasing the size of your ID assists with the review process. All forms of identification must be legible, unaltered, and legitimate. The ID cannot be expired. If the ID appears altered, forged, or illegitimate, we will not be able to proceed with your service request. Student IDs, work IDs, birth certificates, and SIN cards are not acceptable.

Examples of Valid Ownership Documents

Store Receipt - must show make, model and serial number (ESN/IMEI/MEID) of the device for which service is being requested, store name, store address and invoice number. Service Agreement - must show dealer/store code, and the make model of the device for which service is being requested. Back of Phone battery must be removed and IMEI must be clearly visible. UPC Code From Box - must show IMEI of the device for which service is being requested. Proof of Activation - must show IMEI of the device for which service is being requested.

EXAMPLES - Following are examples of valid forms of photocopied ownership documents:

Store Receipt UPC Code From Box Service Agreement Back of Phone Proof of Activation

Please handwrite service request ID # on all documents, forms and IDs before faxing. Once your service request is ready for
completion or to check the status of your service request, visit phoneclaim.com/fido.

You may call Asurion at 1-866-327-3399 if you have questions regarding these instructions or this Affidavit form

Instructions
Control # F-017-54 TEN Rev 1

DO NOT FAX THIS PAGE

EDT: 7/18/12 RDT: X/X/X

AFFIDAVIT
ALL FIELDS ARE REQUIRED AND MUST BE FILLED IN (PLEASE PRINT) USING BLUE OR BLACK INK.
Mail Documents to:

Fax Documents to 1-866-546-0332

Attn: Review Team PO Box 1106 Moncton NB E1C 8P6

Note: If mailed, the service request process will be dependent on timeline of mail delivery and will take longer to complete your service request than faxing.

Service Request #:

Wireless Device Number (

1. Personal Information of Account Owner:

First Name: _________________________________ Last Name: ___________________________________ Daytime Phone Number: _______________________ Evening Phone Number: ________________________ E-mail address: _____________________________________________________________________________ Important: Please clearly write your E-Mail address, as Asurion will proactively contact you to confirm that we received and processed your documents. Your email address will only be used for service request updates and information. Home Address: ______________________________________________________________________________ City: ____________________________________________ Province: __________ Postal Code: ________________

2. Equipment and Service Request Details

Device Manufacturer (Ex. Motorola, Blackberry, etc.): Model (Ex. TorchHSP, 9780, etc.): Check one (1) of the following Your phone was Lost Stolen Damaged (Dropped, Liquid Damage, Broken, etc.) Malfunctioning: Date of occurrence : __________________ Place of occurrence: _______________________________________ Detailed description of what happened to your phone: ________________________________________________

___________________________________________________________________________________
Note: If your phone was damaged or malfunctioning, you are required to return it to Asurion upon receipt of your replacement phone.

3. Attach Photocopy of Your Valid Government Issued Photo ID Check type of photo ID you are attaching:
Provincial or Federal Issued ID card Drivers License Passport Police Force ID Firearms ID Military ID

4. Attach Photocopy of an Ownership Document (See examples on instruction page)

Check type of ownership document you are attaching: Store receipt Copy of UPC bar code Service Agreement Back of Phone

You will not need to provide valid ownership documents if your equipment was received from Asurion. Note: If we are unable to verify this information, you may still be asked to submit ownership documentation.

5. Service Request Agreement

Fulfillment of this service request to _______________________ is hereby authorized and in consideration of such payment Asurion is discharged forever from all further service requests and by reason of the said loss or damage. All rights to recovery from any other person are hereby transferred to the Asurion which is authorized to bring action in the Account Holders name to enforce such rights. All right, title and interest in the device or any part of equipment thereof is hereby transferred to the Asurion only in the event that this service request is based upon the whole value of the device because it has been lost or stolen and the Account Holder agrees immediately to notify Asurion in the event of its recovery.

I understand that if I fail to return the damaged property for which this service request is made, I am subject to, and authorize a non-return fee of up to $400 to be charged under the service request using the method of payment used to originally file this service request. I ________________________ do solemnly declare that the foregoing service request and statements are to the best of my knowledge and belief true in every particular, and I make this solemn declaration conscientiously believing it to be true and knowing that it is the same force and effect as if made under oath.

Signature: ____________________________________

Date:

Once your service request is ready for completion or to check the status of your service request, visit phoneclaim.com/fido.

Control # F-017-54 TEN Rev 1

EDT: 7/18/12

RDT: X/X/X