To,

eBIZ House
B-18, Sector 63
Noida, U.P.
201301

Dear Sir,
Since I am residing in a rural area where postal services are not very
effective, hence I request eBIZ.com Pvt. Ltd. to ship / send my eBIZ
Holiday Accommodation Package, welcome kit (containing the Agamya
watch) at the address of ____________________________________
(name of recipient), who is my _____________________ (relationship
of recipient) having the telephone number ________________ (phone
number of recipient) residing in the urban area where ____________
_______________________________________ (select one - First
Flight, DTDC, or Professional Courier) Courier services is fully active.

The Address of the above mentioned is stated below

Name

______________________________

Address

______________________________
______________________________
______________________________

Telephone no.

______________________________

Only the eBIZ Holiday Accommodation Package welcome kit

(containing Agamya Watch) should be sent / shipped to this alternate
address.

Sincerely Yours,

-------------------------(Signatures)

Name

: ______________________________

TID

______________________________

DID

______________________________

Phone no

: ______________________________

Enclosures: I am enclosing my photocopy of one of the following

government registered photo identifications:

Drivers License
PAN Card
Voter ID
(Please select one)