BHARAT SANCHAR NIGAM LIMITED Affix self (http://www.bsnl.co.in) signed passport size FORM FOR ADD ON FACILITY photograph [OPENING / CLOSING] (required for ISD facility only) 1. Telephone Number : 2. Name of the Customer (in Capital Letters) SURNAME FIRST 3. Address where the telephone is working House No Street/ Road/ Village 4.A Facilities to be opened: I SD CLI otline onferencing Abbreviated Dialling ny Other 4.B Facilities to be closed: I SD CLI otline onferencing Abbreviated Dialling ny Other I agree to pay the prescribed charges, as amended from time to time. Signature of Customer/ Authorised Signatory Signed on Date
