Cleaning/Correction of Mobile Sim Record

UNDERTAKING
By Complainant:
I Mr. /Ms ____________________________________________________
S/O, D/O _____________________________________________________
Resident of ___________________________________________________
do hereby solemnly that following SIMs/connections are in my use:A:
B:
C:
D:
E:
F:

_____________________
_____________________
_____________________
_____________________
_____________________
_____________________

G:
H:
I:
J:
K:
L:

_____________________
_____________________
_____________________
_____________________
_____________________
_____________________

Please block any other number(s) issued / registered against my NIC/CNIC number
forthwith and oblige.
Signature of the complainant:

_____________________

Thumbs impression of the complainant:

_____________________

Date of Complaint:

_____________________
(To be filled by Mobile Company)

By M/s _____________________

Complaint Ref #: _____________________

M/s_____________________ do herby undertake that it shall regularize/block all mobile

number(s) issued against above mentioned NIC/CNIC, other then above mentioned
mobile numbers, within 45 days of this application / complaint and will update its
database accordingly.
Customer Service Center Representative Name

_____________________

Customer Service Center Representative ID

_____________________

Customer Service Center Representative Sign

_____________________

Note: Documents to Checked / Attached.

A: -

SMS received from 668 seen on complainant mobile phone.

Y/N

B: - Original NIC/CNIC seen (incase of family member, then for both Y / N

intended and original complainant).
C: -

NIC/CNIC copy obtained and attached with this form.

Y/N