FASTWAY TRANSMISSION PVT. LTD.

Lajjya Tower,Near P.F.Building,Sham Nager,Sham Nagar,Ludhiana-141001
Tel: 0161-4300000,4300055 Website:www.fastway.in

Customer Name…………………………………………………………….

SAF No………………..

Mob no………………………………………………………………………………

Date………………………

Address 1 ……………………………………………………………………..

Customer ID……………………….

Address 2 …………………………………………………………………………………..
Address 3 ………………………………………………………………………………………
Sr.no

Fastway Package

STB NO

VC NO

STB NO

VC NO

STB NO

VC NO

1 FW Silver
2 FW Gold
3 FW Platinum
4 FW HD
Sr.no

Fastway Package
1 FW Silver
2 FW Gold
3 FW Platinum
4 FW HD

Sr.no

Fastway Package
1 FW Silver
2 FW Gold
3 FW Platinum
4 FW HD

Lco name ………………………………
Lco Code……………………………….
Lco Mob-No …………………………………..

Signature of BM
…………………………………..

Signature of Lco ………………………………….
Checked By ……………………………………………

Authorised Signatory

Processed By ……………………………………………

…………………………………….

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