BHARAT SANCHAR NIGAM LIMITED (http://www.bsnl.co.in) FORM FOR ADD ON FACILITY [OPENING / CLOSING] 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 Bldg./Appt. Area/ Locality/ Tehsil City/ District Pin 4.A Facilities to be opened: STD ISD CLI Hotline Conferencing Abbreviated Dialing Any Other 4.B Facilities to be closed: STD ISD CLI Hotline Conferencing Abbreviated Dialing Any Other I agree to pay the prescribed charges, as amended from time to time. Signature of Customer/ Authorised Signatory Signed on: Date Affix self signed passport size photograph (required for ISD facility only)