BHARAT SANCHAR NIGAM LIMITED
(http://www.bsnl.co.in)

FORM FOR ADD ON FACILITY

[OPENING / CLOSING]

 

Affix self signed passport size photograph (required for ISD facility only)

 

 

     

1. Telephone Number :

 

 

 

 

 

 

 

 

  2. Name of the Customer (in Capital Letters) SURNAME FIRST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  3. Address where the telephone is working

House No

 

 

 

 

 

 

 

Street/ Road/ Village

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bldg./Appt.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Area/ Locality/ Tehsil

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/ District

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pin

 

 

 

 

 

 

 

 

4.A Facilities to be opened:

STD

 

ISD

 

CLI

 

Hotline

 

Conferencing

 

Abbreviated Dialling

 

Any Other

 

 

 

4.B Facilities to be closed:

STD

 

ISD

 

CLI

 

Hotline

 

Conferencing

 

Abbreviated Dialling

 

Any Other

 

 

 

I agree to pay the prescribed charges, as amended from time to time.

 

 

 

 

 

 

Signature of Customer/ Authorised Signatory

 

 

 

 

 

 

Signed on:

Date