MAHANAGAR TELEPHONE NIGAM LIMITED

ORDER - FORM FOR NEW TELEPHONE

(Please read the instruction at the back before filling the form)

A.       APPLICANT PARTICULARS

  1.   A. Title/Name of the Customer (Last name First)/Company/Firm/Organization

  2.   B.  Name of Father/Husband/Group/Proprietor/Partner(s)

     

3.	Existing working connections including Mobile:  MTNL Nos.   ………..                                                                              Others:            ………

                                                                                                           

   4.  Complete installation Address

Flat/Plot       No.

Floor

Building

 

  

Street

Locality

 

City

N

E

W

D

E

L

H

I

Pin

1

1

0

0

    (Copy of Proof of Identity and Residential Address to be attached (see instruction 7) 

 

 5.   Billing/Correspondence Address (if different from 4 above)

Flat/Plot No.

Floor

Building

 

  

Street

Locality

 

City

N

E

W

D

E

L

H

I

Pin

1

1

0

0

 

  6.    E-mail address (if any) ………………………………@…………..

 

7.  No. of  new connections required

8.  Subscriber Category

      (See instruction 13)                                                                      (Please write Code No. as indicated in instruction No.10)

 

9.

Category:   Residential

Business

Govt.

PSU

Statutory Body

Any other

 

  10.       TARIFF  PLAN OPTED  (See instructions 9) :………………………

 

11. Whether subs.fitting (wiring) is required from MTNL   Y/N

 

B.   ADDITIONAL FACILITIES REQUIRED ( Tick whichever is required):

12.

STD

ISD

Conferencing

Call Forwarding

Abbreviated dialling/Any other

 

13.

Telephone instrument required:    Normal

CLIP

Cordless with CLIP

Answering M/c

Not required from MTNL

 

C.

Payment Details: DD/Cheque No.

Dated

 

Drawn on :

 

Branch:     .

D.

14.  Telephone No. of subscriber/ DSA Code  recommending you for MTNL connection (Please see instruction 11)

 

15.

Your Contact No. :

(State whether PP)

 

16.

Old Tel No. of come back Sub., if applicable (See instruction 14)

 

17.   Registration required in National Do Not Registry (free of cost)   :     Yes/No

E   DECLARATION

I hereby declare that information given above is true to the best of my knowledge and I will abide by the prevailing Telegraph Act/Rules framed thereunder & Tariffs as amended from time to time.  I am not a defaulter on account of non-payment of bills for any telecom service provided by MTNL.  In the event of any dispute concerning any telecom line, apparatus or appliance, service, bill etc., between me/us and MTNL, the matter will be referred to the sole Arbitrator, appointed by a nominated authority in MTNL, and shall be governed by the provisions of the Arbitration and Conciliation Act. 1996.

Signature of Customer/Authorised Signatory

Signature of Customer/Authorised Signatory

Date :                                                                      

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

ACKNOWLEDGEMENT/IDENTITY SLIP

(To be handed over by the applicant at the time of installation) (See instruction No. 12)

CA No.

Received from Shri/Smt. ………………………………………………………whose signature are given below, an application for new  telephone connection

 

                                              (Signature of MTNL Officer/Official)

(Signature of subscriber)                                                                                                          Dated at New Delhi………

                                                                                

INSTRUCTIONS FOR FILLING THE FORM FOR NEW TELEPHONE CONNECTION

 

1.      The form may be filled up in Capital letters only.  

2.      A rebate is admissible on installation charges if the telephone instrument and/or internal wiring is arranged by the subscriber.

3.      In case of sole proprietary concern, proprietor may sign himself and affix rubber stamp.

4.      In case of Partnership concern, all partners or any one of the partners duly authorised or Person with the Power of Attorney may sign.  In case of Company, signature should be of a person on behalf of Company, in accordance with the provisions of its Articles of Association.  In case of Partnership concerns, copy of (i) Power of attorney for authorisation & (ii) Partnership Deed and in case of Limited Company, a copy of the articles of association, may be attached.

5.      In case of Govt. Departments, authorised person may sign and affix rubber stamp.

6.      Relevant documents should be duly attested by Central /State Government Officers in respect of Concessional Groups and Special Categories indicated against instruction in 10.

7.      Submission of attested photocopies of any of the following documents shall be considered appropriate as proof of personal Identification and address, as the case may be.

Attestation by a Gazetted Officer, Bank Manager, Notary or any authority authorised would be acceptable.  In case of difficulty in getting attestation the customer can bring originals with photocopies to the concerned Commercial Officer.

(i)                   Paid Telephone/Gas/Water/Electricity/Credit Card/House Tax bill receipt, allotment letter of accommodation issued by Estate Office of the govt. of India/Govt. of Delhi, NDMC/MCD/DDA. 

(ii)                 Income Tax Returns. 

(iii)                Election Identity Card issued by Election Commission of India.  

(iv)                Driving License. 

(v)                 Passport.

(vi)                Rent Receipt of rented house.

(vii)              Notarized personal affidavit on Rs. 10/- Non judicial Stamp Paper declaring the address and profession of  the applicant.  (viii) rent/Lease agreement.

8.      If at any stage information furnished is found false - Telecom Service/Telephone provided is liable to be disconnected immediately without any notice 

9.      A copy of the present tariff structure is enclosed.  Please specify the tariff plan to be opted in item 11 of the application form. The Plan for either voice  or internet be indicated. The tariff applicable can be changed by MTNL without notice.

10.  Subscriber Category, Concessions available and documents required (only if claiming concessional tariff) Concession is available only in standard tariff plan, which at present is ‘Plan 250’.

S.N	Subs Catgry.	Entitled persons/organizations	Concessions available	Documents to be attached (duly attested by Central/State Govt. Gazetted Officer)
1.	01	Business	Nil
2.	02	Residential	Nil
3.	03	Non Residential Telephones in Schools / Universities / Colleges / Institutions / Homes for aged/orphanage etc. recognized by Govt.	25% Concession in Rental	Recognition Certificate
4.	04	Blind persons	50% Concession in Rental	Visually blind certificate from C.M.O. of a Govt. Hospital.
5.	05	War Widows/Disabled soldiers	50% Concession in Rental and no installation charges.	Documentary evidence, copy of PP0 (for war widows)
6.	06	Freedom Fighters	50% Concession in Rental and no Installation charges	Copy of PPO and identity Card.
7..	07	Gallantry/President’s Police Medal for Gallantry Awardees	No Rental and no. installation charges	Copy of Award letter.
8.	08	Serving DOT employees	Rent free with free calls as available to normal subscribers	Service Certificate, Service Book entry proof.
9.	09	Retired DOT employees	No Rental and free calls as below: Gr.A=1000+Normal Free Calls Gr..B =500+Normal Free Calls Gr.C = 300+Normal Free Calls Gr.D =200 +Normal Free Calls	Copy of PPO and other documentary Proof.
10.	10	Senior Citizen	Rental Rs.187.50	Age above 65 Years.  Age proof required

 

 

11.     In case you were recommended by some existing subscriber of MTNL/DSA  for the new connection being applied, Please indicate his Tel.No. or, DSA code as the case may be, in item 14.

12.     The tear off slip would be an identity proof & it should be made over to Line staff at the time of installation by the applicant.

13.     In case of more than one connections, an additional proforma is required to be filled up

14.     If you were an old MTNL customer, please write the number for Loyalty Points Award. Efforts will also be made to allot the same number, if feasible.

 

        

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