Please read the information below and enter the applicable details

This form is to be used to lodge a rebate request as per the Service Level Agreement (SLA).

This form should only be used by Customers who have a defined Service Level Agreement with Internode. If you are unsure about whether you should use this form, please contact your Sales Representative or Account Manager.

Please complete this form and press the submit button at the bottom. Note: We will endeavour to respond to you within 14 days regarding your rebate request.

Your Internode client number appears in the top right corner of your Internode invoices (eg. A123456). If you do not know your client number, please contact Internode for assistance.

Your Internode Customer Details
Your Company Name as it appears on your Internode invoice:
Internode Client ID Number	eg. A123456 (appears in the top right of your invoice)
Name of Person to Contact:
Contact Email Address:
Contact Phone Number	Example: 0881234567
Service Details
Service Type and ID (if applicable)	Example: Business ADSL / A123456
Internode Username associated with the service:	eg. user@snmp,, site@a123456.ibc.on.net
Start date of Downtime:	-- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / -- 1 2 3 4 5 6 7 8 9 10 11 12 / ---- 2007 2008 2009 eg. 24/01/2007
Start time of Downtime:	eg. 10:00 (please specify in 24 hour format)
End date of Downtime:	-- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / -- 1 2 3 4 5 6 7 8 9 10 11 12 / ---- 2006 2007 2008 eg. 24/01/2007
End time of Downtime:	eg. 18:45 (please specify in 24 hour format)
How was Internode Notified of the downtime:
The name of the Internode Staff Member you liaised with:
Ticket Reference Number allocated for this fault:	eg. 1234567
Further Comments: (optional)