P.O.

Box 1047 Addis Ababa Ethiopia

tel.: +251 (0) 115 505 678
fax: +251 (0) 115 515 777

የአገልግሎት ማቋረጫ መጠየቅያ ቅፅ

APPLICATION FORM FOR SERVICE TERMINATION REQUEST SD-F12

33 የደንበኛው መረጃ/Customer's Information

የደንበኛው ሙሉ ሥም/ Customer Full Name ፡ _________________________________________________________

የአገልግሎት አይነት/ Service Type ፡ _________________________________________________________

የአገልግሎት ወይም የአካውንት ቁጥር/ Service or Account No.፡ _________________________________________________

የደንበኛው መገኛ ስልክ ቁጥር/ Contact Number: _________________________________________________________

አገልግሎቱ እንዲቋረጥ የተጠየቀበት ምክንያት/ Reason for Service Termination Request

የአገልግሎት ጥራት ችግር/Poor quality of service አድራሻ በመቀየር አና በአካባቢው አገልግሎቱ ባለመኖሩ/
Location change to where there is no network
ተደጋጋሚ የአገልግሎት ብልሽትና የጥገና መዘግየት/ resource
Repetitive line fault & maintenance delay
በስህተት የተሸጠና ተመላሽ የሚደረግ/
የአገልግሎት ክፍያ መወደድ/ Expensive Tariff Wrongly sold and to be reversed

ሌሎች ምንያቶች ( ይገለፅ)/ Other reasons

የክፍያ መጠራቀም አና መክፈል አለመቻል/ Unable to pay bill
________________________________________
ሌላ አገልግሎት ለመጠቀም /
________________________________________
Replaced by other alternative service

ለድህረ ክፍያ አገልግሎት ብቻ/ For Postpaid Service Only

ይህን የአገልግሎት መቋረጥ ካመለከትኩ በኃላ እንዲቋረጥ በጠየኩት አካውንት ላይ ማንኛውም ቢል ያልወጣለት የአገልግሎት ክፍያ ቢኖር
ክፍያውን በወቅቱ እንደምከፍል አረጋግጣለሁ፡፡
This is to confirm that I commit for any outstanding balance of bills and/or any bills to be issued after the signature of this
application form and to settle all unpaid bills for the specified service number/account number.

የደንበኛ ስም/Customer Name: ___________________ የአገልግሎት ማዕከል ስም/ Service Center Name: ____________________

ፊርማ/ Signiture: _______________________ አፅዳቂ ሱፐርቫይዘር/ Approver Shop Supervisor): __________________

ቀን/ Date: _______________________ ፊርማ/ Signiture: ____________________________________________

ቀን/ Date: ____________________________________________

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