Registration No. 		     AGREEMENT FORM FOR
           GARUDA
      WILL MOBILE SERVICE





   Garuda Copy
Please use only a ballpoint pen while filling the form. Write in BLOCK CAPITALS only. Tick the appropriate box.

Type of Application     Individual      Company       Other specify)__________________Any Existing MTNL No.  

PLEASE TELL US ABOUT YOURSELF
Title             Mr.       Mrs.        Ms.   Dr.   M/S  Other (specify)
Name                                                  
                                                          Father's/Husband's Name
  (In case of individual)  
Date of Birth   Marital Status   Single Married Profession__________Nationality__________
                  DD      MM     YY		                 Self
            Attested
              Photo
Residential Address 


         City   Pin 
Telephone No.(s)                        Fax. No.                             E- Mail ______________________________
Office/Business  Address 


         City   Pin 
Telephone No.(s)  1.                 2.                      3.           Fax. No.       

Bill to be sent to        Residential Address         Office/Business Address

TARIFF/SERVICE DETAILS
Tariff Plan Chosen (code)     Hand set Plan Code  
  Local Only Local & NSD   Local,NSD & ISD  CLIP   Voice Mail Service  UNC   NO REP  BUSY      Call FWD
Other Service(Specify)_____________________________________________________ Please refer to tariff card for more details .

PAYMENT PARTICULARS

STATUTORY REQUIREMENT
Total Amount Rs.   Bank ____________________
Pay Order/DD No.  ________________________
Dated                     Branch Code
                         DD    MM   YY		 PAN No. or GIR No.  or   Form 60
PAN/GIR No._______________________
Note: In case PAN No. attach copy of PAN Card.
        Form 60 to be filled separately.

DECLARATION
1.I declare and undertake that the above information is wholly true. I have read and understood the terms and conditions mentioned overleaf.I hereby agree to abide by them. I have gone through the details of the tariff Plan mentioned above ,which I understand ,may change from time to time. I also agree that my GARUDA connection is subject to verfication,evaluation and acceptance by MTNL.

                                                                                                                                                                  
 Dated ________________                                                                                                                                Subscriber's Signature
*Name of the Authorized Signatory__________________________________________________   
* Designation _____________________________________________________________           * Seal of the Company

* For Corporate

INSTRUCTIONS

FOT MTNL USE ONLY
1.Application will be registered on payment of individual security deposit. Common Bank Draft for more than one application will not be accepted.
2.Type of Application : Individual/partnership/proprietorship/Ltd. Co/Public instt./Society/association/Trust/PSU/Govt./Statutory Body/NRI/Foreign National.
3.Please furnish the attested proof of address of residence/office by any these:  a) Ration Card b) Photo Identity card c) Passport d) Election Card e) Driving License f) Latest paid MTNL or DVB Bill g) Any other Govt. document containing photograph.
4.Please present any of the above photograph carrying document in original for verification by the MTNL officer at the booking counter .
5.Self attested photograph to be affixed by the applicant. In case the applicant is a public Ltd.Co/Govt. Body the photograph is not required.
6.Public limited  Cos. may enclose certificate of incorporation, memorandum of articles, duly signed by MD/Director of Company along with any proof of Identity as above of the authorized officer of the company. In case application is signed by authorized signatory  ,then attested copy of power of attorney must be attached .
7.In case of Govt. of India  Undertaking,Govt. of India offices/State Govt. officers, the aforesaid requirements are dispensed with and self certification on the letter head will suffice along with the name and designation of the coordinating officer to be consulted in case of need .
8.In case of Foreign Missions in India and other foreign  agencies , the name and designation of the authorized officer along with details of officials etc. for whom the CDMA  WLL -M phone is intended.
9.Payment will be accepted by pay order/Demand draft only in favour of "MTNL Delhi".

 C.A No.  
DIR No.  
CATEGORY  
ESN  

Regd. & Corporate office :Mahanagar Telephone Nigam Limited,Jeevan Bharti Building ,Tower-I,12 th Floor , 124 Connaught Circus,New Delhi-110001





Registration No. 		     AGREEMENT FORM FOR
           GARUDA
      WILL MOBILE SERVICE





   Duplicate Copy
Please use only a ballpoint pen while filling the form. Write in BLOCK CAPITALS only. Tick the appropriate box.

Type of Application     Individual      Company       Other specify)__________________Any Existing MTNL No.  

PLEASE TELL US ABOUT YOURSELF
Title             Mr.       Mrs.        Ms.   Dr.   M/S  Other (specify)
Name                                                  
                                                          Father's/Husband's Name
  (In case of individual)  
Date of Birth   Marital Status   Single Married Profession__________Nationality__________
                  DD      MM     YY		                 Self
            Attested
              Photo
Residential Address 


         City   Pin 
Telephone No.(s)                        Fax. No.                             E- Mail ______________________________
Office/Business  Address 


         City   Pin 
Telephone No.(s)  1.                 2.                      3.           Fax. No.       

Bill to be sent to        Residential Address         Office/Business Address

TARIFF/SERVICE DETAILS
Tariff Plan Chosen (code)     Hand set Plan Code  
  Local Only Local & NSD   Local,NSD & ISD  CLIP   Voice Mail Service  UNC   NO REP  BUSY      Call FWD
Other Service(Specify)_____________________________________________________ Please refer to tariff card for more details .

PAYMENT PARTICULARS

STATUTORY REQUIREMENT
Total Amount Rs.   Bank ____________________
Pay Order/DD No.  ________________________
Dated                     Branch Code
                         DD    MM   YY		 PAN No. or GIR No.  or   Form 60
PAN/GIR No._______________________
Note: In case PAN No. attach copy of PAN Card.
        Form 60 to be filled separately.

DECLARATION
1.I declare and undertake that the above information is wholly true. I have read and understood the terms and conditions mentioned overleaf.I hereby agree to abide by them. I have gone through the details of the tariff Plan mentioned above ,which I understand ,may change from time to time. I also agree that my GARUDA connection is subject to verfication,evaluation and acceptance by MTNL.

                                                                                                                                                                  
 Dated ________________                                                                                                                                Subscriber's Signature
*Name of the Authorized Signatory__________________________________________________   
* Designation _____________________________________________________________           * Seal of the Company

* For Corporate

INSTRUCTIONS

FOT MTNL USE ONLY
1.Application will be registered on payment of individual security deposit. Common Bank Draft for more than one application will not be accepted.
2.Type of Application : Individual/partnership/proprietorship/Ltd. Co/Public instt./Society/association/Trust/PSU/Govt./Statutory Body/NRI/Foreign National.
3.Please furnish the attested proof of address of residence/office by any these:  a) Ration Card b) Photo Identity card c) Passport d) Election Card e) Driving License f) Latest paid MTNL or DVB Bill g) Any other Govt. document containing photograph.
4.Please present any of the above photograph carrying document in original for verification by the MTNL officer at the booking counter .
5.Self attested photograph to be affixed by the applicant. In case the applicant is a public Ltd.Co/Govt. Body the photograph is not required.
6.Public limited  Cos. may enclose certificate of incorporation, memorandum of articles, duly signed by MD/Director of Company along with any proof of Identity as above of the authorized officer of the company. In case application is signed by authorized signatory  ,then attested copy of power of attorney must be attached .
7.In case of Govt. of India  Undertaking,Govt. of India offices/State Govt. officers, the aforesaid requirements are dispensed with and self certification on the letter head will suffice along with the name and designation of the coordinating officer to be consulted in case of need .
8.In case of Foreign Missions in India and other foreign  agencies , the name and designation of the authorized officer along with details of officials etc. for whom the CDMA  WLL -M phone is intended.
9.Payment will be accepted by pay order/Demand draft only in favour of "MTNL Delhi".

 C.A No.  
DIR No.  
CATEGORY  
ESN  

Regd. & Corporate office :Mahanagar Telephone Nigam Limited,Jeevan Bharti Building ,Tower-I,12 th Floor , 124 Connaught Circus,New Delhi-110001

 

RECEIPT OF CDMA WLL MOBILE HANDSET

Received MTNL's GARUDA Mobile connection against

Registration No......................................................................Dated..................................................

OB No...................................................................................Dated..................................................

Telephone No........................................................ CA No...............................................................

Handset Sl.No.......................................................ESN..........................................................

Handset Make...................................................... Model No............................................................

The Telephone is having following accessories :

(1)   Telephone  (2)   Battery    (3)   Charger     (4)   User's Manual

Signature of Applicant  : .................................................................

Name of applicant .............................................................................................................................

Counter Sign. of SDE (I/C)............................................................. 

    

SEAL OF SDE  (I/C)

Name of SDE(I/C).............................................................................................................................

Name of GSC/Telemart.......................................................................................................................

Date.............................

Dear Customer ,

    MTNL is pleased to install /provide a CDMA WLL-M Telephone No............................................

vide OB No................................................................ Dated................................................Our staff

will be introducing you to this service for your convenience . We are committed to provide the best of

service . In case of any help needed or any complaint please don't hestiate to contact Garuda Helpdesk

at 2000 0000 (2 All Zeros service ) or any of our Garuda Service Centers .

The Telephone is having following accessories :

(1)   Telephone  (2)   Battery    (3)   Charger     (4)   User's Manual

 

 

                                                                                                        Signature & Seal of SDE ( I/C )

 

   

SPECIMEN SIGNATURE SHEET

Name of Applicant ( In Capital letters)..........................................................................................

....................................................................................................................................................

Specimen Signature(1)...............................................................(2) .............................................

                                                (For Office Use Only)

Registration No.:..............................................................Dated ................................................

OB No.: .........................................................................Dated ................................................

_________________________________________________________________________

Name of Applicant ( In Capital letters)..........................................................................................

....................................................................................................................................................

Specimen Signature(1)...............................................................(2) .............................................

                                                (For Office Use Only)

Registration No.:..............................................................Dated ................................................

OB No.: .........................................................................Dated ................................................

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

                        HANDSET ISSUE SLIP      

This ISSUE SLIP is to be produced at the MTNL counter for "taking delivery of the CDMA WLL Mobile Handset "/" Programming and Activation of Subscriber's Handset". If a person other than the applicant himself  is to collect the handset on his behalf , an authorization letter should accompany this  Issue SLIP.

Name of Applicant ..................................................................................................................

Registration No.:..............................................................Dated ..............................................

CA No.: ..................................................................................................................................

 

Signature & Seal of SDE(I/C)                                                       Signature of Applicant
Name of SDE(I/C): ..............................................
Name of Sanchar Haat/Telemart/CSC:........................................................................
Date: ..................................................
Signature of Recipient /Applicant.........................................................(To be signed in front of SDE(I/C) while taking
 delivery of Handset for verification).

FORM NO. 60

(See third provison to rule 114B)

Form of Declaration to be filled by a person who does not have either a permanent  Account Number or General index register number and who makes payment in cash in respect of transaction specified in clauses (a) to (h) of rule 114B .

  1. Full Name and address of the declarant

          ..................................................................................................................................

          ..................................................................................................................................

          ...................................................................................................................................

   2.    Particular of transaction

   3.    Amount of transaction

   4.    Are you assessed to tax?        Yes/No

   5.    If yes,

   (i) Details of Ward /Circle /Range where the last return of income was filed ?

   (ii) Reasons for not having Permanent Account No./General Index Register No. ?

    6.    Details of the document being produced  in support of address in column (1)

           ........................................................................................................................

                                                            Verification

    I, ............................................................................................do hereby declare that what is stated above is true to the best of my knowledge and belief .

Verified today, the ........................................... day of.......................(Month), 2003

Date .............................

Place ............................

                                                                                                            .........................................

                                                                                                            Signature of the declarant