MAHANAGAR TELEPHONE NIGAM LIMITED, MUMBAI

APPLICATION FOR SHIFTING OF TELEPHONE (ON ALL INDIA BASIS)

(To be filled up in duplicate with specimen signature sheet)
To______________________
Sub : Shifting of telephone No._____________________
Sir,
Please arrange for shifting of my/our telephone No___________________________________
as per particulars given below :-
1. Name of the Subscriber :
(In block Letters)
2. Father's/Husband's Name :
(In case of individual)
3. Address for correspondence :
4. Permanent address :
5. Location where the telephone is working :
6. State whether the telephone is working at present
or whether it has been disconnected under shift/
safe custody due to non-payment of bills etc. if so,
give full particulars of disconnection and date :
7. Category under which the telephone was booked :
( Tatkal/OYT/OYT(S) Non-OYT(SS)Non-OYTGenl.NOYT/spl.)
8. Registration particulars at the time of originalbooking for telephone & date of its installation :
9. Accessories presently working on the telephone :
10. Address where the telephone is required to be shifted :
11. Reason for shifting :
Dated
Signature of the subscriber
Note :- Photocopy of latest paid bill should be attached
FOR OFFICIAL USE ONLY
1. Whether the telephone is working or disconnected.
2. Date of disconnection.
3. Outstanding bills of the subscriber, if any.
Accounts-officer(TR)
Sign. of Applicant
attested by G. Officer/Manager of Nationalised Bank.
SPECIMEN SIGNATURE SHEET FOR SHIFT OF TELEPHONE TO OTHER
STATION
(To be filled by the applicant in duplicate)
Telephone No._____________________
Name___________________________
Address where the telephone shift is working :
Address where the shift is required :Specimen Signature :
1._____________________________________ 2. _____________________________________
3. _____________________________________ 4. ____________________________________
FOR OFFICE USE
Certified that telephone No.___________________________________________ for shift to
_____________________________________ has been closed on _______________________
in the name of ____________________________________________________ and a certificate
No. ____________________ date _______________________ has been issued to the subscriber
This is specimen signature sheet duly verified with office records is being sent for keeping in
record for further necessary action at your end.
Signat
ure
Name of Officer :_____________________
Designation__________________________
Telephone No________________________
Dated :
Seal :