BHARAT SANCHAR NIGAM LIMITED

APPLICATION FORM FOR

BSNL LEASED INTERNET SERVICES
(For Leased Lines and ISPs)

For Office Use Only

Customer Code
Billing Code
Date Received

Attn: Commercial Officer

Dear Sir,

I/We wish to apply for BSNL leased Internet Services. Necessary particulars are as follows:

1. Name of the Company/ Applicant :_________________________________

2. Whether applicant is an ISP _____________________________

2.1 If Yes , License Details :______________________________________

(Please attach copy of the License)

2.2 Category of License (Tick appropriate)

A B C

2.3 Area of Service Provisioning - ______________________________________

3. Billing Address : _____________________________________

_____________________________________

______________ Pin Code_______________

4. Contact Name :__________________________________

Phone No. : __________________________________ Fax No. : ___________________________

E-mail : __________________________________

5. Line Speed
(Tick line speed)
64 Kbps 128 Kbps 256 Kbps 512 Kbps 1 Mbps 2 Mbps
6. IP ADDRESSING & ROUTING DETAILS

6.1 PREFERRED ROUTING

Static Routing or BGP, if BGP provide AS Number________
(For BGP the customer should be multihomed and must have an AS number)

6.2 Source of IP Addresses along with the details of addresses (Specify Address & Mask)

Source I.P. Address Remarks

APNIC ( -------- -------- --------- -------- APNIC (IP Address range obtained from
APNIC Must be registered in their database
in the name of Applicant / Company)

BSNL -------- -------- -------- -------- BSNL (To obtain IP addresses from BSNL,
refer Guidelines for obtaining IP addresses
for leased lines)

VSNL -------- -------- -------- --------

Other -------- -------- -------- -------- Any Other Sources (Please Specify)
(Specify)

7. Payment Particulars:

Cash/DD No. Bank Name Branch Date Amount

8. Any other relevant information

I have gone through the Broad Terms and Conditions of the services at Annexure I and agree to abide by
the same.

Signature
Date: Applicant's Name

NOTE:
1. Leased line applications should be accompanied with request on letter head and additionally a copy of
license for an ISP.

2. All Cheques/DDs should be drawn in favor of -------------------------------------------------------------------

-------------------------------------------------------------------------------

3. For accounts related queries, please contact BSNL Commercial Officer. Technical support is available
from BSNL help desk in all cities.

(Latest Tariff details available at www.bsnl.co.in)

 ANNEXURE-I
Broad Terms and Conditions of BSNL Leased Internet Services

1. BSNL shall
a. Endeavor to provide reliable & efficient services to its customer.
b. Update its Internet services, provide new facilities, modify & delete certain features
without prior intimation.
c. Upgrade its network capacity, bandwidth, speed & add new nodes & reconfigure its
network as per need.

2. BSNL may revise the tariff for its Internet services & its value added services from time
to time to on its sole discretion.

3. Value Added Telecom service providers shall get necessary permission/licence from Dy.
Director General (CS), Department of Telecommunications, Sanchar Bhavan, 20 Ashoka
Road, NEW DELHI-110 001 [Tel: 3326255 / 3032855, - Fax: 3327656]

4. In case of an ISP, all terms & conditions of ISP license shall be applicable

5. The customer understands and acknowledges that :

a. Only Telecom Engineering Center (TEC), New Delhi approved Interface Equipment
would be used for accessing Internet Services.

b. Necessary License Fee is payable to BSNL for connecting Modem/other Interface

equipment etc. as applicable. The PSTN customer is required to complete necessary
formalities with local BSNL office.

c. Interactive voice and fax messaging shall not be permitted on BSNL Internet Services
network, as such selling/promoting Internet Telephony/Fax etc., is prohibited.

d. Sending unsolicited messaging via BSNL Internet Services is unlawful.

e. Probing for means of gaining unauthorized access to computers or networks, is not

permitted.

f. Forgery of any identification or obscuring of hostnames, usernames, IP addresses, or

any message header information in any data, is not permitted.

g. Sending harassing or threatening transmissions over BSNL leased Internet Services is

not permitted.

h. Internet contains unedited materials, some of which may be sexually explicit or

offensive & provocative for which BSNL has no control. Any objectionable or obscene
messages or communications, which are inconsistent with the established laws of the
country, are not created, stored downloaded, accessed, transmitted or retransmitted by
him or any other person using his facilities.

i. The customer is required to fully comply with the provisions of the Indian Telegraph
Act, 1885, Indian Telegraph Rules made thereunder and Information Technology Act
2000 and any amendments or replacements made thereto from time to time.

j. Customer assumes total responsibility and risk for use of the Internet Services.
6. Payment of bills - It would be the responsibility of subscriber to make advance payment
of BSNL leased Internet Services. BSNL would disconnect the service in case of non-
receipt of advance payment without giving any notice to the subscriber.

7. Upon a breach of any understanding, the BSNL shall have the right to terminate this
agreement without any notice. The customers violating any of understanding do so at
their own risk.

8. Disclaimer :- While every effort is made by BSNL to provide highest quality of services
to its customers of Leased Internet Services, the linking, quality and speed of data
transmission is entirely dependant on the telephone line/ leased line connectivity as may
be permitted by MTNL/BSNL systems. Accordingly, BSNL shall in no event be
responsible to the customer in any manner whatsoever for any failure, defect, delay in
connectivity or accidental loss of connectivity of the customer with BSNL network
computer or the deficiency in data transmission between the customer and BSNL network
computers, or for any inconvenience, damage or loss that may be caused to any one or of
any kind arising therefrom.

The Internet Service is provided by BSNL on an "AS IS and AVAILABLE" basis

without warranties of any kind, either express or implied, including but not limited to
warranties of title, non-infringement or implied warranties of merchantability of fitness
for a particular purpose.

No advice or information given by BSNL, its affiliates or their respective employees shall
create a warranty. Neither BSNL nor its affiliates warrants that the service will be
uninterrupted or error free or that any information, software or other material accessible
on the service is free of viruses, worms, Trojan horses or other harmful components.
Under no circumstances shall BSNL, its affiliates or its contractors be liable for any
direct, indirect, incidental, special, punitive or consequential damages that result in any
way from customers, use of or inability to use the service or to access the Internet or any
part thereof, or customers reliance on or use of information, services or merchandise
provided on or through the service, or that result from mistakes, omissions, interruptions,
deletion of files, errors, defects, delays in operation, or transmission, or any failure of
performance.

9. Force Majeure - If at anytime, during the continuance of BSNL Internet Services, the
performance in whole or part, of any obligation under it shall be prevented or delayed by
reason of war, hostility, acts of the public enemy, civil commotion, sabotage, fire, flood,
explosion, epidemic, quarantine restriction, strikes, lock-out or act of GOD etc., the
subscriber shall not have any claim for damages against BSNL in respect of such non-
performance or delay in performance of BSNL Internet Services.

10. Arbitration of Disputes - In the event of any question, dispute or difference arising out of
provisions of BSNL Internet Services, the matter shall be referred to the sole arbitration
of the Chairman and Managing Director, Bharat Sanchar Nigam Limited, New Delhi.
DECLARATION

I/WE have carefully read the terms and conditions of the agreement and technical
specifications of BSNL Internet Services and agree to abide the same.

For Office Use Only

Customer Code
Date Received
Billing Code

Signature of Customer

(Name of Customer in Capitals)

Date Place
………………………………………………………………………………………………

BHARAT SANCHAR NIGAM LIMITED

ACKNOWLEDGEMENT SLIP

Received Application Form for BSNL Leased Internet Service from the subscriber with the detail given below:

1. Name
2. City

3. Connection Details

SPEED

64 Kbps 128 Kbps 256 Kbps 512 Kbps 1 Mbps 2 Mbps

For Office Use Only

Customer Code Date Received
Name
Signature
Seal