ISP-II
MAHANAGAR TELEPHONE
NIGAM LIMITED,DELHI
APPLICATION
FORM FOR INTERNET ACCESS RENEWAL
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FOR OFFICE USE ONLY Password Reference No.------------- |
FOR HELPDESK USE
Signature-------------- |
1.Name of the
Applicant -------------------------------------------
2.User/Login ID ------------------------------------------------
3.Address, Contact No. ------------------------------------------
4.RENEWAL OPTED :(Please tick your choice)
(a) Full Renewal
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PSTN Dial up |
PSTN Unlimited plan |
ISDN 64 Kbps |
ISDN 128 Kbps |
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100Hrs |
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One Month |
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100 Hrs |
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100 Hrs |
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250 Hrs |
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Three Months |
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250 Hrs |
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250 Hrs |
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500 Hrs |
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Six Months |
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500 Hrs |
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500 Hrs |
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Twelve Months |
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1000 Hrs |
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1000 Hrs |
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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
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Annexure | General Instruction
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