FORM 3A

(FORMAT FOR SIM BLOCK CONFIRMATION TO BE CERTIFIED BY SERVICE PROVIDER)

Date: ..

Customer Service Manager

Reg: Barring Services to Mobile No:

Dear Sir,

I wish to inform you that my mobile No.

been stolen on

_ along with the SIM Card has

. (Please mention date & time of incident)

Accordingly, I hereby request you to kindly block all the incoming and outgoing calls for the said
number.
Please do the needful and terminate the service on receipt of the said letter.
Thanking you,

Signature of SIM Owner

Address

(TO BE CERTIFIED BY SERVICE PROVIDER)

This is to certify that the prepaid/ postpaid Mobile No:

Mr. /Mrs.

Stands in the name of

at

address_
AND the customer is using the mobile as Pre paid/
Post Paid as per our records. The SIM card is replaced in lieu of theft of mobile on
___________________ (please mention date of theft).

Seal & Signature of Service Provider

(THIS LETTER TO BE ISSUED ONLY BY THE AUTHOURISED OUTLETS OF SERVICE PROVIDER)