ISP-III
MAHANAGAR TELEPHONE NIGAM LIMITED,DELHI
APPLICATION FORM FOR MISCELLANEOUS INTERNET ACCESS SERVICE
|
Signature------------ |
Execution Date--------- Signature-------------- |
1.Name of the Applicant
-------------------------------------------
2.User/Login ID
------------------------------------------------
3.Address, Contact No.
------------------------------------------
4.Miscellaneous Services
opted:
a)Change of login
id
(1)-----------------(2)---------------------
b)Additional/Mail
memory ----------(MB)
c)Additional personal Web
space
----------(MB)
d)Additional email
id
(1)-----------------(2) ---------------------
e)Fixed IP
access
PSTN
ISDN
5.Payment particulars :
Cash /DD No.---------------------
Date------------------------Amount----------------
Bank Name
------------------------------- Branch
----------------------------------
Date
:----------
Signature of Applicant
RECEIPT
Recieved from
Mr./Ms-------------------------------------------------------------------------
Rs.------
-(In
words,Rs.---------------------------------------------------------------------)
Vide
Cash/DD No.--------------------------------------
Dated------------------------------
Drawn on
------------------------------------------------------(Bank's Name & Branch)
Customer Code-----------------------
Signature
| Annexure | General Instruction |