EM/T&IT/001
T&IT-ADSL - 17/11/005
Thanlyin Star City Project
Estate Management
Telecoms & IT (Operation ) Department
ADSL Application Form
Date : 1-11-2017
(1) Customer Information
Customer Name Mr.Ellie NRC/Passport No
Building No. B3 Apartment No 304
Email Address Contact Phone No
(2) ADSL Services Requested
Class of Speed 512Kbps 4 1Mbps 2Mbps 5 Mbps EM 4
Subscription Period 12 Months 6 Months 4 3 Months 1 Month OMP
New Installation Extened 4 New Modem Purchase
(3) Billing Information
No Description From To
1 Extend 1-Nov-17 31-Jan-18
Period (Per
Description Price (Per Month) Amount (MMK)
Month)
Activation Fee 100,000 -
1 Mbps Modem Fee 50,000 3 -
Data Usage Fee 65,000 195,000
New Moderm 50,000 -
Discount on Data Usage 5,000
Account Name - Utility Operation Sub Total 190,000
Account No - 000110288500386 5% commercial Tax 9,500
BankNameYomaBank TOTAL 199,500
Applicant Name Mr.Ellie Signature
" Notice - ADSL Internet Line will be setup within 2 days after cash receive."