MAHANAGAR TELEPHONE NIGAM LIMITED
No.
Valid upto----------------------
| Affix a passport size photograph of the applicant duly signed by him
and attested by a Gazetted Officer or 1st class
magistrate |
The Area G.M/Area Manager
MTNL Delhi Telephones
New
Delhi
With reference to your
advertisement Dt -----------I,the undersigned hereby apply for a Pay Phone with
local and STD/ISD Call facility.I have read the terms and conditions given in
the draft contract document supplied with the application form and agreed to
abide by them or any amendments made thereto by DOT/MTNL from time to time.The
relevant particulars are given below.
1.Name of the Applicant
(in
English in block letters)
2.a)Name of
Father/Husband
b)Nationality
c)Educational
Qualification
d)Whether unemployed
3.Parmanent Address of
Applicant
4.Address for correspondence
5.Full address
and exact location
where the STD/ISD Pay phone is
proposed to be set
up
6.Give a brief description of the Public place
and public
interest at the proposed location e.g
(Commercial ,Housing
Societies,Resettlment Colonies,
Govt.Colonies, Family Qrs. of Defence
Personnel ,
Student Hostels,Bus stands,tourist
Centres,Railway
Stations,Airports,Pilgrim Centres Hospital,
Educational
Institution,Public libraries and Charitable Institutions).
7.(1)State
if the applicant falls in any of the preferential categories
viz.(Handicapped
persons including blind persons).
Ex-serviceman,War-widows,Retired DOT
Employees or
their dependents ; SC/ST ,Dependents of freedom
fighters,Charitable
Institutions and hospitals.Attach supporting
documents.
(2)Details of document attached in support of 7(1)
above
(The copies submitted should be duly attested by Gazetted
officer/1st Class
Magistrate).
8.Whether any telephone is already working for the
applicant
any where in Delhi or in India ?If so,number (s) may be
furnished indicating the category under which obtained.
9.Contact
Telephone Number
a)office
b)Residence
10.State whether any
DOT/MTNL dues are outstanding
against the applicant for any telephone
/telecom
services in his name (or even in some other name at his
premises).
if so particulars thereof may be given.
11.(1)Telephone No.
of the nearest Telephone
working from the proposed location of site
(required to identify the exchange area).
(2)State whether any Pay
phone with STD /ISD
facility is functioning at the same
address.
(3)In your locality or nearby giving an idea
of the location
and approximate distance of
the nearest STD/ISD Payphone/Telecom centre
known
to you from your place
12.Indicate whether the proposed premises
for
setting up the booth is owned or rented and whether
permission from
concerned authorities is available .
(The permission from concerned
organisation ,Govt body /Civic Body/
landlord will be the sole
responsibility of the applicant)
13.(1)Indicate amenities available and
additional
Services proposed /being provided at the premises
(like
sitting space/working table etc.)
(2)Specially the timing for which
services from
payphone will be kept available to puiblic with
minimum
6.00 A.M to 11.00 P.M for 17 hours
but preferably round the
clock.
14.Attach a copy of the sketch showing the location of the STD/ISD
booth.
15.Specimen Signature
Signature of applicant
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