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CUSTOMER APPLICATION RELIANCE Wl DTU 702872039822 1 eae of ince Glowsaton Fomor Sve Liexponie— Bleoer Cieoce anecie 2. Product Type 3 Mobile [)Ostacard CI FWP GREET Pco 120/06 5. Prepaid to Postpaid [ Postpaid to Prepaid Reorder 4. gustomer/ Company Name iNET ‘Atberzed Signatory a Desiomsion No. t Connections: SFaverstibets Name ANA = 6 Gonder: OM Ge 7. pate o ith” ($716) [1] [VATZI #. pane no. COCO ose 9: Nanay [an Frsign Natoma Pasaport No Vasomytm eno. an verve yp _} 10. Ateato Mobi No.1 $1) TRIVISI| | 1. mat = =_ 12. Number ot Mtl conmacton dn name of psa 11. Local & Bing Address : House No." HSU steer Cit 19AGa) 0 Landman OLA PO Lag EF ow Eta ates eat ~ Sa 12 Permanent Adresse: House No ‘steer ae, ai a L 13: Prater por Document! 073 36) ming tee ia. 14, Proot ot Actress (pon) OF EV. Smmbh ODOUR auc 1204 pace of ove CIE TT tssing Authority: E12O- 15 Local reference of utattion customer Name age, ire ee pa = z 16.Tantt Pan spp’ ______17.Medeot Payment : [Cash [) Cheque [) Greta 0) pebtcad Os! Oi ecs Serene crt Ror ane) —__ ow 77) T=) BEETS) Cert humoreaton Cove eka ae zs ranch Name A Address ______________“7ypeof Depost: 1 Securty epost I LD Depost [) Otters (Passe speci) EET] rem L] oo] com [Ines Fess So ym ee pate ner ern reenmeeeneeeng esihetoretiwees ientataravearnere Toot Pap Poca onoTe oO: mang oie ee bn 220

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