Affix self

signed passport
size photograph
(required for
ISD facility
only)

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

Hotline

Conferencing

Abbreviated Dialing

Any Other

4.B Facilities to be closed:

STD

ISD

CLI

I agree to pay the prescribed charges, as amended from time to time.

Signature of Customer/ Authorised Signatory

Signed on:

Date

Instructions
1. For CLI facility equipment has to be arranged by the customer which should be TEC
approved. Rs.50/- per month is payable for this facility in addition to processing fee of
Rs.50/- for every request for provision/ closure of the facility.
2. Additional Charges are payable for Abbreviated Dialing, Call Transfer, Hotline Facility and
Conferencing Facility. The Applicable Charges are Rs.20/- per month per facility or a total
sum of Rs.60 per month will be charged for availing the four facilities simultaneously.