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    Mahanagar Telephone Nigam LTD: Landline Triband Dolphin Data Isdn Trump Voice

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    indianroadromeo
    1. The document is an application form for various telecommunication services provided by Mahanagar Telephone Nigam Limited (MTNL), including landline, broadband, GSM, fiber-to-the-home (FTTH), and CDMA services. 2. It requests information such as the applicant's name, address, contact details, identity proof, service options, payment details, and signature. 3. The form collects essential customer details to process the application for telecom connections and services from MTNL.

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    © All Rights Reserved
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    Mahanagar Telephone Nigam LTD: Landline Triband Dolphin Data Isdn Trump Voice

    Uploaded by

    indianroadromeo
    26 views2 pages
    1. The document is an application form for various telecommunication services provided by Mahanagar Telephone Nigam Limited (MTNL), including landline, broadband, GSM, fiber-to-the-home (FTTH), and CDMA services. 2. It requests information such as the applicant's name, address, contact details, identity proof, service options, payment details, and signature. 3. The form collects essential customer details to process the application for telecom connections and services from MTNL.

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    1. The document is an application form for various telecommunication services provided by Mahanagar Telephone Nigam Limited (MTNL), including landline, broadband, GSM, fiber-to-the-home (FTTH), and CDMA services. 2. It requests information such as the applicant's name, address, contact details, identity proof, service options, payment details, and signature. 3. The form collects essential customer details to process the application for telecom connections and services from MTNL.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    26 views2 pages

    Mahanagar Telephone Nigam LTD: Landline Triband Dolphin Data Isdn Trump Voice

    Uploaded by

    indianroadromeo
    1. The document is an application form for various telecommunication services provided by Mahanagar Telephone Nigam Limited (MTNL), including landline, broadband, GSM, fiber-to-the-home (FTTH), and CDMA services. 2. It requests information such as the applicant's name, address, contact details, identity proof, service options, payment details, and signature. 3. The form collects essential customer details to process the application for telecom connections and services from MTNL.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
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    Passport

    MAHANAGAR TELEPHONE NIGAM LTD size


    Mahanagar Doorsanchar Sadan,5th Floor,9 CGO Complex,Lodhi Road,New Delhi-110003 photograph
    Web Site Address: http://www.mtnl.net.in Cross signed by
    Applicant
    BASIC SERVICE BROADBAND GSM FTTH GARUDA (CDMA)
    *1. Type of service required LANDLINE DOLPHIN DATA
    TRIBAND
    Please tick ( ) ISDN TRUMP VOICE

    *2 Type of applicant:
    TITLE SURNAME FIRST MIDDLE
    *3.Name Mr Mrs Ms Dr
    *4.Father's/Husband's Name
    *5.Date of Birth(DD/MM/YY) *6.Sex M / F *7 Nationality
    (Date of incorporation in case of company)
    8. Profession 9.Education 10.Marital Status Single Married
    11.Average income per month(Rs) a) < 10,000 b) 10,000 -20,000 c) 20,000 -30,000
    d) 30,000 -50,000 e) > 50,000
    *12.Residential Address/
    Installation Address
    (Proof to be attached )
    13. E-mail Id: PIN CODE
    14.Billing/Correspondence Address
    (If different from above)
    Local Address (For PIN CODE
    outstation customers)
    *15.A) PAN NO./ GIR NO. ( If PAN No. not available please fill form 60)
    16.Existing MTNL Tel No.(if any) Existing Customer A/C No.

    17.i) Type of any other service of MTNL or other Operator used by you
    ii) Tel No of that service a) b)
    *18.Tariff Plan opted: Service(1) Tariff Code Service(2) Tariff Code
    Service(3) Tariff Code Service(4) Tariff Code
    *19.Option for Receiving Bill
    *20. Option for Bill payment
    21(a) Whether subs. Fitting (wiring) is required from MTNL. Y/N
    *21(b) Whether Telephone Instrument is required from MTNL Y/N
    *21(c) Whether Modem is required from MTNL Y/N if yes Non Wi-Fi Wi-Fi
    *22. Any additional Value added services requ Yes No VAS Mob. No.
    22.(a) Tariff Plan for value added service
    23. NDNC Option: Yes No
    *24.Type of Identity proof submitted & its No.:
    24(a) Aadhaar No (optional)
    *25. Mode of payment for Registration: Cash / Cheque / DD Rs.
    Cheque/DD No. Date:
    Bank account no. Name of Bank & Branch on which Cheque /DD drawn
    (in case of cheque)
    * Columns are mandatory Customer's Signature
    For office use
    Booked By Name of CSC/Distributor/MBA: CSC/Distibutor Code
    Customer A/c Number
    Landline /Mobile No. SIM No./ESN No.
    ----------------------------------------------------------- Tear here ---------------------------------------------------------------------------------------------------
    ACKNOWLEDGEMENT SLIP
    Received an application form for service from with the payment
    of Rs. in cash/through cheque/DD
    Signature & Name of MTNL officer with stamp Date:

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