Robi Axiata Limited Version: 6.

Third-Party Declaration form

** Applicable only for third-party user/access.
Company Information (Third-party)
Company Name : Digicon Technologies Limited
Address: 242, Tejgaon I/A, Gulshan Link Road, Dhaka-1208, Bangladesh
Website: http://www.digicontechnologies.com/
Details of the service provider/person needing access
Name Deb Kumar Saha NID/Passport 19925617057000270
House# 01, Road# 15,
Personal address Contact number 01674895827
Sector#12, Uttara, Dhaka.

I have chacked the details and found correct. The person is working under my supervision.

___________________________
Signature of Robi SPOC (Person raising the e-approval)
(Need to be a permanent employee of Robi)

Name: Rafi-Al-Razi
Employee ID: 10003825
Date: 01-01-20

Declaration for Third-party user:

I understand and accept the rights that have been granted to me. I take full responsibility for the login name and password issued and I
agree that I/my company will be held responsible for any breach of confidentiality or actions resulting from misuse. I agree that I have
responsibility to exercise care in the treatment of personal data and to ensure that such information is not disclosed to any unauthorized
person. In addition, I agree that me/my organization will not attempt any unauthorized access to systems or data, and will not load
unauthorized software onto the Robi network.

I have been duly appointed by my company to receive login credentials from Robi

I understand that this access will be disabled after the duration as mentioned in the form.

______________________________________
User Signature (of the service provider/person needing access)
Date: 01-01-2020

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