Videsh Sanchar Nigam
Limited
Mumbai - 400 001
Kind Attn : Customer Relations
Date:
Dear Sir,
I / We wish to renew my / our Internet Account which is registered with VSNL / Mumbai. The particulars of my / our Account are as follows :
| 1. Email Address | : | |
| . | ||
| 2. Name of the Applicant | : | |
| . | ||
| 3. Contact Address | : | |
| . | ||
| 4. Contact Name | : | |
| . | ||
| Phone No. | Fax No. | |
| . |
5. Account Type ( Tick Only One )
| Service | Terminal Dial Up | TCP / IP | ||
| 100 Hrs | 250 Hrs | 500 Hrs | ||
| Option | [ ] | [ ] | [ ] | [ ] |
| Payment | Rs. 5,000 /- | Rs. 2,400 /- | Rs. 5,200 /- | Rs. 8,000 /- |
.
6. Payment Particulars
:
( i ) DD / Pay Order
( ii ) Amount Bank
.
Place :
Date : Signautre :
...
..
For Office Use
| Date of Renewal | |
| Customer informed on | |
| Siganture of officer : |