Ownership Transfer Form 376065 grameenphone SL.No. \Use Block Letters (ftw over fry) I : 2 Individuals Company authorized person/esmath aire . Piconeeh Company Name (coma xa Fst Name Cex me. Department ery Last Name ares acm ee. Father's Name(Pets =m) Husbana's Namecara. cs a a Tel cPeye (Res 0) = SE z = City enn Postal Code (ob ete... Televcer (Office Fe) —— Facer. _ hereby transfer /s and assign /s this subscription owned by myselt/ the company bearing (owt sm / ceric waa tor rrr) Bulk subscriptions/acpe meat Fes) [i] Yes. please atoch he PhonenoccwmrmlOlti7) J 1 | J | | i 4 SiMNumbercPmmeneseeolL I-11 titi tiuiis | ALC 1 cao ea) Reference Mobile Number rarer oreoren | 1 17. ‘along with all assets and liabilities incurred thereto in favour of res ew oP Pea /U a A et FTN) 5 See wa RIN ew NOTE: hereby also deciare that! shall have no cai over the balance (if avallable & applleable In my transfered SIM endin this regard. Gramesnphone's decision shall be considered ial and concusive. AH oes Wit Art aE, SEN ART Si TIO CR oF eds es) ree CITA ART a CG, AR a PT TE w CTR BOT | Transferee Vea. 1G Ingivicuavef® Company authorized personvcernt re Company Name (cerfia ts) / First Name (aeces mn srene.. Photograph Department ReryLast Name ras a er. Father's Name (Prem amy) Husband's Name eis =2 Tel Pe (RES EA on vninnnnnan Ot AdR OSS (MN... Chtyem v= Postal Code (HP OME) nn Tel aA (Dice wen) i Fax... ‘hereby also assure the transferee that according to the terms and conaitions of the Subscription Agreement (sift erat err PHOT a, eaceeT e wHTRo HH) dated (Ef)... ‘thereof and | am entitled to transfer and assign the same. (as at < =efierics ems ep oe aE RA CHM ‘sete WA) | (HA) transferee (#ftet)/campany authorized person (corn frm hereby fully agree and accept this tansfer and aiso taking all the lables, if any, lett by the sald transferor with Grameenphone Lid, and | will satisfy Grameenphone Ltd, an demand without assigning any reason whatsoever, (or (xeres effet) aowat o% were of areibain set ars oR CHIE earereta A GH AAC Ree Pe as are Fern ocr ah ets ct amt Co ta IM Crm oma aN Bet CE oon ee with Grameenphone Ltd,J am the owner NOTE: "Howarth Tensor of Owmenp Cartst sll be steciva sui ptetograph, signature and ther forenion ‘erieston ofthe angina sibscion paper of th Trantor (38 HEP eae Tec, eae Pr SY ae A, UT OO WHE ee a wee EET |) Place & Date Transferor Transferee For Grameenphone Ltd Wo HE Ree ‘ater aot nearer Pe aa AF