Fax to Email Signup

Please enter your phone system requirements in the form below. When you submit the details, a Simtex consultant will review your requirements and contact you to finalise any details and, if you are ready to order, start the provisioning of your new phone system as soon as required.

Step 1 of 4 - Your Information

Contact Details
Are You*
- A new Simtex customer
- An existing Simtex customer
Where did you hear?*
Tell us where you heard about Simtex services.
Account Number*
Please provide your Simtex Account number. This will be listed on any Simtex invoice or receipt.
Reseller
If you were referred to Simtex by a reseller please enter their company name here.
Title
Contact Name*
First Last
End-User Authorised E-Mail*
Enter Email Confirm Email

This address will be authorised to make changes on your Simtex account, as well as the recipient for all accounts correspondence (invoices etc).
Tech Contact E-Mail*
Enter Email Confirm Email

Your technical contact will be authorised to make changes on your account.
Reseller/CC Contact E-Mail
Enter Email Confirm Email

If you would like us to keep another person informed of the application status, simply add them here.
Company Name*
BN, ABN, ACN*
Physical Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Work Phone*
Include area code and no spaces
Home Phone
Include area code and no spaces
Mobile
No spaces
Fax
Include area code and no spaces

Fax to E-Mail (PDF)
Simtex offers a simple solution for those of us who need to receive paper dinosaurs - faxes!
A simple $8.00 per month fee, plus an additional or existing DID for $1.95 per month is all that's required to have your own virtual fax service. Faxes sent to you are delivered via e-mail with a PDF attachment.
Fax to E-Mail
- Yes, I would like a Fax to E-Mail Service
Fax to E-Mail*
- Fax to E-Mail - existing/ported DID (1000 pages/month) $9.95
- Fax to E-Mail - new DID (1000 pages/month) $9.95
Please note - if you are moving an existing number to Simtex, a number porting form must be completed in addition to this form. A link to this form will be provided at the end of this application.
Fax DID Location*
Other Fax DID Location*
Include the SZU or description of the area required. If possible, include details of a number which is close to the requested area.

For example: Burnie, Tasmania, 03 6430 XXXX
E-Mail Destination*

Faxes will be sent to this e-mail address as a PDF attachment
Upfront Charges Total
$ 0.00
Recurrring Total
$ 0.00

Payment options
Payment Type
- Credit Card
- Direct Debit
Credit Card*

MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Direct Debit Details
“You” request and authorise Highway1 (Aust) Pty Ltd (Debit User ID 375019) to arrange, through its own financial institution, a debit to your nominated account any amount Highway1(Aust) Pty Ltd, has deemed payable by you. This debit or charge will be made through the Bulk Electronic Clearing System (BECS) from your account held at the financial institution you have nominated below and will be subject to the terms and conditions of the Direct Debit Request Service Agreement.
Account Holders Name*
Bank Name*
Branch/BSB*
Account Number*

Summary
Terms and Conditions*
- I have read and understood the terms and conditions available HERE.
Email Contact*
- I have understood and agreed that Simtex may contact me via authorized 3rd party email services for important notifications.
Additional Notes
CAPTCHA
Upfront Charges Total
$ 0.00
Recurring Total
$ 0.00
Total Charge
$ 0.00

Fax to Email Signup

Step 1 of 4 - Your Information

Contact Details

Fax to E-Mail (PDF)

Payment options

Direct Debit Details

Summary

Who is Simtex?

Company

Address

Contact