APPLICATION FOR ISDN REGISTRATION

APPLICATION FOR ISDN REGISTRATION

Price Rs. 10/- For ISDN Registration

Fee Rs. 3000/-

MAHANAGAR TELEPHONE NIGAM LIMITED MUMBAI

(Under Rule 414 of the Indian Telegraph Rules 1951) Date of Issue ----------

(Valid for twelve Calender months from the date of Issue)

Sl. No. 735765 Valid upto -------------

To,

The Chief General Manager (Commercial Section).

Mahanagar Telephone Nigam Limited

Mumbai Telephones, Mumbai

For Office Use Only

Application No. C 0965500

Date of issue -------------------------

C.A. No. -------------------------

Telephone Exchange -------------------------

Note Please read instructions before filling application from

Name of applicant

Title (Dr., Er., Adv. etc.)

Surname First name Second Name

Please leave one column blank between Surname, First Name and Second Name

Category (Tick in the appropriate box)

1. N.OYT-G 3. N.OYT-SS 5. OYT-G 7. Tatkal

2. N.OYT-S 4. N.OYT-SWS 6. OYT-S 8.

4. Dialling facility required

1. Local Only 2. Local & NSD 3. Local & NSD & ISD

5. 1. Residential 2. Business 3. Government

6. Status of applicant --------------

See Instructions

7. Concessional Group ----------------

See Instructions & Attach supporting documents

8. Whether applicant shall provide wiring within his/her premises ? Yes/No

9. Whether applicant shall use his/her own Telephone instrument? Yes/No

10. Payment particulars Amount Rs.----- Mode of payment (Pay Order/DD/cheque)

Pay Order/DD/Cheque No. Dated------- Date----- Month----- Year-----

Bank & Branch -------------------------------------------------------

11. Telephone Installation address

House/Flat No. Floor No. Building/Apartment Plot No.

Street/Road/Lane Locality/Village/District

City PIN

12. Address for correspondence

House/Flat No. Floor No. Building/Apartment Plot No.

Street/Road/Lane Locality/Village/District

City PIN

13. Existing telephone numbers (if any) Fax Number (if any)

Nearest Telephone No.

14. Is there any telephone working in the name of the applicant anywhere /If Yes

Telephone Number----------------------

Address ---------------------------------------------------

15. Billing Address

House/Flat No. Floor No. Building/Apartment Plot No.

Street/Road/Lane Locality/Village/District

City PIN

16. If the application is for an EPABX Junction, indicate if MAIN or SUBSEQUENT

------------------------------

If SUBSEQUENT, indicate MAIN telephone number ------------------

17. If the applicant is a Partnership Firm or Hindu Undivided Family (HUF),

please furnish the following

Name of the karta of HUF -------------------------------------------------

Name in full of members of HUG/Partnership Father's Name Relation to Karta

Firm

---------------------------------- --------------------- ----------------

18. Nominee

Name -----------------------------------------------------

Address --------------------------------------------------

Relation to applicant ------------------------------------

19. I/We hereby declare that in respect of the service provided against the application, I/We will abide by the Indian Telegraph Rules as amended from time to time.

Date

Place

Signature of the applicant(s)

DUPLICATE APPLICATION FORM

(TO BE COMPLETED AND RETURNED ALONGWITH PRESCRIBED APPLICATION)

MAHANAGAR TELEPHONE NIGAM LIMITED, MUMBAI

Application for Telephone Valid for one year from the date of issue

Connection

(Under Rule 414 of Indian Telegraph Rules 1951)

For Office Use Only

Application No. C 0965500

Date of issue -------------------------

C.A. No. -------------------------

Telephone Exchange -------------------------

Note Please read instructions before filling application from

Name of applicant

Title (Dr., Er., Adv. etc.)

Surname First name Second Name

Please leave one column blank between Surname, First Name and Second Name

Category (Tick in the appropriate box)

1. N.OYT-G 3. N.OYT-SS 5. OYT-G 7. Tatkal

2. N.OYT-S 4. N.OYT-SWS 6. OYT-S 8.

4. Dialling facility required

1. Local Only 2. Local & NSD 3. Local & NSD & ISD

5. 1. Residential 2. Business 3. Government

6. Status of applicant -------------- 7. Concessional Group ----------------

See Instructions See Instructions & Attach supporting documents

8. Whether applicant shall provide wiring within his/her premises ? Yes/No

9. Whether applicant shall use his/her own Telephone instrument? Yes/No

10. Payment particulars Amount Rs.----- Mode of payment (Pay Order/DD/cheque)

Pay Order/DD/Cheque No. Dated------- Date----- Month----- Year-----

Bank & Branch -------------------------------------------------------

11. Telephone Installation address

House/Flat No. Floor No. Building/Apartment Plot No.

Street/Road/Lane Locality/Village/District

City PIN

12. Address for correspondence

House/Flat No. Floor No. Building/Apartment Plot No.

Street/Road/Lane Locality/Village/District

City PIN

13. Existing telephone numbers (if any) Fax Number (if any)

Nearest Telephone No.

14. Is there any telephone working in the name of the applicant anywhere /If Yes

Telephone Number----------------------

Address ---------------------------------------------------

15. Billing Address

House/Flat No. Floor No. Building/Apartment Plot No.

Street/Road/Lane Locality/Village/District

City PIN

16. If the application is for an EPABX Junction, indicate if MAIN or SUBSEQUENT

------------------------------

If SUBSEQUENT, indicate MAIN telephone number ------------------

17. If the applicant is a Partnership Firm or Hindu Undivided Family (HUF),

please furnish the following

Name of the karta of HUF -------------------------------------------------

Name in full of members of HUG/Partnership Father's Name Relation to Karta

Firm

---------------------------------- --------------------- ----------------

18. Nominee

Name -----------------------------------------------------

Address --------------------------------------------------

Relation to applicant ------------------------------------

19. I/We hereby declare that in respect of the service provided against the application, I/We will abide by the Indian Telegraph Rules as amended from time to time.

Date

Place

Signature of the applicant(s)

MAHANAGAR TELEPHONE NIGAM LIMITED MUMBAI

C 0965500 Specimen Signature of each person

SPECIMEN SIGNATURES SHEET

Application Form No. ------------------------------- SPECIMEN SIGNATURES-I

Regn. No.-----------------------Dated --------------

Name of the Applicant (In Block Capital Letters)

----------------------------------------------------

Application Form No. ------------------------------- SPECIMEN SIGNATURES-II

Regn. No.-----------------------Dated --------------

Name of the Applicant (In Block Capital Letters)

----------------------------------------------------

Application Form No. ------------------------------- SPECIMEN SIGNATURES-III

Regn. No.-----------------------Dated --------------

Name of the Applicant (In Block Capital Letters)

----------------------------------------------------

INSTRUCTIONS TO BE FOLLOWED FOR FILLING APPLICATION FORM

1. Please fill the boxes in block letters only.

2. The price paid for the application form is not subject to refund or adjustment and form is valid for a period of one year from the date of issue.

3. The application will be registered on payment of individual registration fee. Common bank draft for more than one application will not be accepted.

4. Individual must sign if the application is in individual individual's name.

5. In case of proprietory concern, proprietor must sign himself and affix rubber stamp.

6. In case of partnership concern, all partners or any one of the partners duly authorised or manager with the power of attorney may sign. In case of company, signatures should be of a person on behalf of the company, in accordance with the provisions of its Articles of Association.

7. In case of Govt. department, authorised person may sign and affix rubber stamp.

8. Copy of Documents duly attested may be attached as applicable :-

(a) Power of attorney in case of authorisation

(b) Registered partnership deed or partnership deed with from A issued by Registrar of Firms.

(d) In case of Limited Co., a copy of the Articles of Association.

(e) In case of special category/concessional group. the relevent documents

9. Status of Applicant (please indicate one of the following) (fill in block letters only)

I. Individual VII. PSU

II. Partnership VIII. Govt.

III. Proprietorship IX. Statutory body

IV. Ltd. Co. X. HUF

V. Public Inst. XI. NRI

VI. Society/Association/Trust XII. Foreign National

10. Concessional groups (Please indicate one of the following as applicable):

I. Freedom Fighter IV. Disabled soldier

II. Gallantory award winner V. Blind person

III. War Widow

11. Payment of registration fee is to be made by Cheque/Pay/Order/Demand Draft only, drawn in favour of "Mahanagar Telephone Nigam Limited, Delhi".

12. Contact Telephone No. (If any) :

Fax No. (if any)

13. Please specify the facilities required in case of ISDN line (Tick mark).

CLIR CF AGC CUG NSN CH CLIP

(a) No. of Terminals proposed to be

used : (Maximum of Eight ISDN

terminals can be connected to

NT 1)

(b) Type of Terminals proposed to

be connected :

(i) Simple ISDN Hand Set Yes No

(ii) ISDN Feature Phone Yes No

(iii) ISDN PC Card Yes No

(iv) Terminal Adaptar Yes No

(v) G4 Fax Terminal Yes No

(vi) Video Telephone Yes No

(vii) Video Conferencing Yes No

Equipment (This

requires 3 ISDN

Telephone Lines)

No. 735765 ANNEXURE - V

MAHANAGAR TELEPHONE NIGAM LIMITED NEW MUMBAI

Four Specimen Signature of each person

SPECIMEN SIGNATURES SHEET

Application Form No.------------------------------------ SPECIMEN SIGNATURES-1

Regn. No.--------------------- Dated -------------------

Name of the Applicant-----------------------------------

(in Block Capital Letters)

Application Form No. ----------------------------------- SPECIMEN SIGNATURES-2

Regn. No.-------------------- Dated --------------------

Name of the Applicant-----------------------------------

(In Block Capital Letters)

Application Form No.------------------------------------ SPECIMEN SIGNATURES-3

Regd. No.-------------------- Dated --------------------

Name of the Applicant-----------------------------------

(In Block Capital Letters)

Application Form No.------------------------------------ SPECIMEN SIGNATURES-4

Regd. No.-------------------- Dated --------------------

Name of the Applicant-----------------------------------

(In Block Capital Letters)