Scribd
Upload
43K views1 page

Official BSNL Landline Closure Form

This document is an application form for closure or surrender of a telephone provided by Bharat Sanchar Nigam Limited (BSNL), India's state-owned telecom company. The form requests information such as the subscriber's name, telephone number, account number, type of telephone, address, date of requested closure, reasons for closure, address for refund of security deposit, and contact details. The subscriber must sign to acknowledge payment of any outstanding amounts even after closure. Upon receipt, the official signs and dates the form.

Uploaded by

Shashank Kumar
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
43K views1 page

Official BSNL Landline Closure Form

This document is an application form for closure or surrender of a telephone provided by Bharat Sanchar Nigam Limited (BSNL), India's state-owned telecom company. The form requests information such as the subscriber's name, telephone number, account number, type of telephone, address, date of requested closure, reasons for closure, address for refund of security deposit, and contact details. The subscriber must sign to acknowledge payment of any outstanding amounts even after closure. Upon receipt, the official signs and dates the form.

Uploaded by

Shashank Kumar
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

BHARAT SANCHAR NIGAM LIMITED

(Website add: www.bsnl.co.in)


APPLICATION FORM FOR CLOSURE/SURRENDER OF TELEPHONE
1. Name of the Subscriber

_____________________________________________

2. Telephone Number

_____________________________________________

3. Account Number

_____________________________________________

4. Type of Telephone

(i)Basic/WLL FWT (ii) WLL Mobile (iii)Cellular Mobile

5. Address of the subscriber

_____________________________________________

6. Date from which the telephone is


required to be closed

-------------------------------------------------------------------____________________

7. Reasons for surrender of telephone


(Please tick the appropriate reason)

: 1.
2.
3.
4.
5.
6.
7.
8.

9.
8. Address on which refund of security
deposit after adjustment of outstanding
bill/amount should be sent

9. Contact telephone No., if any

Moving to some other city/Mobile Licensed Service Area


Being an additional phone, not required
Death of the original allottee
Financial constraints
Closure of business
Taking a Fixed/ Mobile connection from BSNL in place of
Mobile/ Landline
Taking mobile/fixed telephone from other company
Not satisfied with BSNLs service on account of:
a. Billing problems
b. Commercial problems
c. Frequent faults
d. Improper behaviour by BSNL staff
(Please give details)
Any other reasons (please specify):_________________
_____________________________________________
_____________________________________________
_____________________________________________
___________________________

I undertake to pay any amount due to BSNL even after closure of the telephone connection.

Signature of the customer


Name:_________________
Receipt
Received an application for closure w.e.f.______________ of Fixed/ Mobile (Pre-paid or Post-paid)/ WLL(M)/FWT
telephone
connection
No._____________________
working
in
the
name
of
Shri/Smt./Ms
_________________________.Date of receipt of application:_____________. Time of receipt ________________.

Signature of the officer/


Official with seal

You might also like