MAHANAGAR TELEPHONE NIGAM LIMITED

APPLICATION FOR STD / ISD FACILITY

To:- From:-
THE SUB-DIVISIONAL ENGINEER
Quick Customer Services,
_________ Tel.Exchange,
MTNL, Mumbai- Date.
Sir,
I/We the undersigned subscriber(s) of Telephone Number……………… would like to apply
for the following STD/ISD facility of my/our telephone. I/We undertake to pay all the prescribed rentals
and charges.
i) Subscriber Trunk Dialing (STD)
ii) International Subscriber Trunk Dialing (ISD)
Signature of Subscriber(s)
SIGNATURE ATTESTATION BY NATIONALISED BANK/SCHEDULED BANK
1) Name of the A/c holder Shri./Smt./Kum.---------------------------------------------------------------------------
2) A/c. No.___________________________________________________________________________
3) Date of opening A/c__________________________________________________________________
4) Address as per Bank record____________________________________________________________
__________________________________________________________________________________
5) Signature of the A/c holder____________________________________________________________
Certified that the above referred entries are correct and
Shri /Smt./Kum._____________________________________________________________________
has signed in my presence and his/her signature of attested.
Signature of A/c holder Signature _________________________
Name _________________________
Designation _________________________
Staff No _________________________
Note: Filling up of this form is optional in his/her own interest, dully filled and attested to avoid delay
due to variation in signature.
ACKNOWLEDGEMENT
Received the application form for STD/ISD facility on Phone No._____________on _______200__ .
Receiver's Signature with Rubber StampANNEXURE-A
PROFORMA FOR GETTING ISD/STD FACILITY
(To be filled up by the applicant)
Applicable if applicant is individual
Name of applicant :
Father's name :
Address where telephone is to be
Installed/working :
Contact Telephone No. :
Permanent Home Address :
Telephone No :
Bank Account No :
Name of Bank :
Address of Bank :
Proof of Residence :
Signature of applicant :
Give reference of two reputed persons with their names and addresses known to you
your locality:
Name: 2. Name:
Address: Address:
Telephone No Telephone No.
Photo copy of any of the following documents may be enclosed:
Proof of occupation of premises where the telephone is to be provided with ISD/STD facility, Ration
Card / Driving Licence / Election Card / Passport / Society Certificate / Occupancy /Electricity Bill /
Lease Deed. Original of the documents submitted will be produced whenever it is required for
verification.
Passport size
photograph
signed by
the applicant