ISP-IV
MAHANAGAR TELEPHONE NIGAM LIMITED,DELHI
APPLICATION FORM FOR LEASE LINE INTERNET ACCESS SERVICES

FOR HELPDESK USE
Commissioning
Date .........................
LAN
IP .......................................
WAN IP....................
Signature.......
FOR OFFICE USE ONLY
Password Reference
No.-------------
Customer Code--------------
Booking Date--------------
Signature--------
Note:Please read the instructions & broad terms
and conditions before filling up the form.
1.PERSONAL/COMPANY DETAILS
A) Name
B)Billing
Address
Pin C) Contact Phone No.------------------ Fax No.-----------------------
(For informing account details)
D)Contact E-mail Address ------------------------------------------------
2.SERVICE OPTED :(Please tick your choice)
Speed of port Annual basis Short Term
64 Kbps
128 Kbps
256 Kbps N.A
512 Kbps
1 Mbps N.A
2 Mbps
Whether Wi-Fi connectivity will be used for internet access on leased line Yes No
3.PAYMENT MODE: Annual Quaterly
4.TECHNICAL DETAILS:
A)Address where service required ---------------------------------------------------------
---------------------------------------------------------
B)Purpose of lease line ---------------------------------------------------------
5.ADDITIONAL IP ADDRESS REQUIRED :--------------------------- (Address)
6.DOCUMENT ENCLOSED:
1.Block Diagram of Setup Yes No
2.Copy on relevant license agreement Yes No
3.Details of Modems being supplied to MTNL Yes No
7.REBATE REQUESTED:----------------------- give documentary proof if any )
8.PAYMENT PARTICULARS:
DD Number ----------------- Date--------- Amount---------------
Bank Name-------------------------- Branch ---------------
9. DECLARATION
1.I /We hereby undertake that any Wi-Fi connectivity deployed by me/us shall be activated only after it is registered for centralized authentication set up and maintained by me/us or provided by MTNL. (Strike off whichever is not applicable)
2. I/We have carefully read the terms and conditions of the agreement and technical specifications of MTNL Internet access Services and agree to abide by the same.
Date: Signature of the Applicant
RECEIPT
Recieved from Mr./Ms-------------------------------------------------------------------------
Rs.-------(In words,Rs.---------------------------------------------------------------------)
Vide Cash/DD No.-------------------------------------- Dated------------------------------
Drawn on ---------------------------------------------------------(Bank's Name & Branch)
Customer Code/Ref. no.----------------------- Signature
Note:1. Please quote your Customer Code No./Ref.no. for all future communications.

ANNEXURE
BROAD TERMS AND CONDITIONS OF MTNL, INTERNET ACCESS SERVICE SUBSCRIPTION
1. MTNL shall be free to update Internet access progressive to bring in new features with time. MTNL may not be in a position to intimate Customer immediately, however it will endeavor to make it known to subscribers through advertisements.
2. Subscribers are advised to use modems and other gadgets approved by Telecom Engineering Center. In cases where it is necessary to pay license fee to MTNL for connecting modems and other interface equipments, subscribers shall be required to complete necessary formalities with the local MTNL Office.
3. International connectivity is being provided through VSNL right now. Exclusive gateway is likely to be organised by MTNL in future.
4. The current access network is likely to inhibit speeds. Improved speeds are likely to be available in future.
5. The subscriber of MTNL Internet Access Services is not allowed to resale the Internet Services (Except WWW Service).
6. Voice on IP is not permitted as per DOT regulations.
7. The subscriber is required to fully comply the provisions of the Indian Telegraph Act, 1885, and the Indian Telegraph
Rules made thereunder and any amendments or replacements made there to from time to time.
8. The subscriber is required to ensure that objectionable or obscene massages or communications, which are in consistent with the established laws of the country are not made by him or any other person using his password.
9. MTNL may revise the tariff for MTNL Internet Access Services from time to time at its discretion.
10. Customer assumes total responsibility and risk for use of the MTNL Internet Access Services, Neither MTNL nor its affiliates make any express or implied warranties, representations or endorsements whatsoever (including without limitation warranties of title or non infringement, or the implied warranties of merchantability or fitness for a particular purpose) with regard to any merchandise information or service provided through the internet, any they shall not be
liable for any cost or damage arising either directly or indirectly from any such transaction. It is solely customer’s responsibility to evaluate the accuracy, completeness and usefulness of all opinions, advice, services and other information, and the quality and merchantability of all merchandise, provided through the services or in the Internet generally.
11. Customer understands further that the internet contains unedited materials some of which are sexually explicit or may be offensive to some people. Customers access such materials at their own risk. MTNL has no control over and accepts no responsibility whatsoever for such materials.
12. The subscriber is required to deist from putting unsolicited massaging on server hosted at MTNL premises. The subscriber is required to ensure that objectionable or obscene massages or communications, which are inconsistent with the established laws of the country are not made by him or any other person on the Web Server or web space of the subscriber.
13. The service is provided on an ‘AS IS and AVAILABLE’ basis without warranties of any kind, either express or implied, including but not limited to warranties of title, non-infringement or implied warranties of merchantability of fitness for particular purpose. No advice or information given by MTNL, its affiliates or their respective employees shall create a warranty. Neither MTNL nor its affiliates warrants that the service will be uninterrupted or error free or that any information, software or other material accessible on the service is free of viruses, worms, Trojan horses or other harmful components.
14. Under no circumstances shall MTNL, its affiliates or its contractors be liable for any direct, indirect, incidental, special, punitive, or consequential damages that result in anyway from customers use of or inability to use the service or to access the Internet or any part thereof, or customers reliance on or use of information, services or merchandise provided on or through the service, or that result from mistakes, omissions, interruptions, deletion of files, errors, defects, delays in operation, or transmission, or any failure of performance.
15. payment of bills - it would be the responsibility of subscriber to make advance payment to MTNL Internet Access service. MTNL would disconnect the service in case of non-receipt of advance payment without giving any notice to the subscriber.
16. Force Majeure - if any time, during the continuance of MTNL Internet Access Services, the performance in whole or part, of any obligation under it shall be prevented or delayed by reason of war, hostility, acts of the public enemy, civil commotion , sabotage, fire, flood, explosion, epidemic, quarantine restriction, strikes, look-out or act of GOD etc. the subscriber shall not have any claim for damages, against MTNL in respect of such non-performance or delay in performance of MTNL Internet Access Services.
17. Arbitration of Disputes - In the event of any question, dispute or difference arising out of provisions of MTNL Internet Access Services, the matter shall be referred to the arbitration under ICADR Arbitration Rules. 1996/consumer court.
18. Use of Wi-Fi: If it comes to the notice of MTNL that the subscriber is using Wi-Fi without registering for centralized authentication , to be set up and maintained by the subscriber or provided by MTNL , the services to the subscriber shall be suspended till they are registered for centralized authentication .
GENERAL INSTRUCTIONS
1. Please fill each box with CAPITAL LETTERS Only.
2. Demand Draft (DD) is to be drawn in favour of MTNL, Delhi.
3. For future correspondance quote your Login-id/Password ref. number.
4. MTNL Internet Help Desk No is 1504, 23359272 & Fax No. 3359173.
5. The Payment for leased line port will be allowed on quaterly basis although the contract may be of one year duration.
6.The local line Tarrif for the leased line will be charged separately as per the rates applicable.Provision of Modem etc.and Registration ,installation and testing charges will be applicable as per MTNL's tariff for local leased line.
7.8 IP address (LAN)and 4 WAN will be given free of cost.Additional IP Addresses will be charged at the rate as per Tariff for a block of 8 LAN IP Addresses.
8.Short term lease line the services will be available for 1 week or more duration on weekly rate basis applicable upto 10 weeks.
9.Short term installation charges included registration/ installation charges of leased line and will be chargeable at one point only.
10. If Modems are provided by the customers security amount will not be charged.