MAHANAGAR TELEPHONE NIGAM LIMITED
                                                                     (O/O General Manager Central,New Delhi-110001)

Contact Telephone No. (if any):

Please Specify the facilities required in case of ISDN Line (Tick mark)

CLIR           CF          ADC          CUG           MSN           CH           CLIP   


(a) No. of Terminal 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 Handset                                        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 equipment
(This requires 3 ISDN Telphone Lines)                     Yes                     No

                                                                                                                                                   Signature