MAMANAGAR TELEPHONE NIGAM LIMITED
(ebute ndares)
FORM FOR SURRNDER OF CONNECTION
1. Felepbone Ne,
2 Namco tepals =o
3. Address where he telephone is working
Fann. Floor Prot No.
eting L i
Sennen enn Loeaty Hiri
ory
4. Dutean which telephone is roqured tobe closed — ]
5. Reacons for locure Taking alt lodia shi.
(Pleas ick the appropriate SLNo.) SRG within Mumbai
“Tis in un eitonal tetephve
Financial Economie Coediervelosure of
company Business
5. Teri high
6. Surrender of OYT Connection as ile. 15
semand,
11, Taking telephone frm other company
Yok staf wilh serice.
8) Comercial
») Billing
8) Anyother reason
9 Any oer eason Pl specify
Aer scjusiment of otstanting bills, blancs security ifury may plese be relunded atthe address
given below: Thereby undertake to pay any amount due lo MTN. stich comes wo te notice even a ater
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