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    Pakistan Telecommunication Authority

    Uploaded by

    Shafqat Ali
    The document is a customer application form for telecommunication services from the Pakistan Telecommunication Authority. It requests information such as the customer's name, address, CNIC, phone numbers, email, service type, bandwidth needs, and signature. The form also has a section for official use only which includes details of the assigned IP addresses, bandwidth type, activation date and signatures of the authorizing officer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Pakistan Telecommunication Authority

    Uploaded by

    Shafqat Ali
    19 views1 page
    The document is a customer application form for telecommunication services from the Pakistan Telecommunication Authority. It requests information such as the customer's name, address, CNIC, phone numbers, email, service type, bandwidth needs, and signature. The form also has a section for official use only which includes details of the assigned IP addresses, bandwidth type, activation date and signatures of the authorizing officer.

    Original Description:

    PTA

    Original Title

    PAKISTAN TELECOMMUNICATION AUTHORITY

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    © © All Rights Reserved

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    The document is a customer application form for telecommunication services from the Pakistan Telecommunication Authority. It requests information such as the customer's name, address, CNIC, phone numbers, email, service type, bandwidth needs, and signature. The form also has a section for official use only which includes details of the assigned IP addresses, bandwidth type, activation date and signatures of the authorizing officer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    19 views1 page

    Pakistan Telecommunication Authority

    Uploaded by

    Shafqat Ali
    The document is a customer application form for telecommunication services from the Pakistan Telecommunication Authority. It requests information such as the customer's name, address, CNIC, phone numbers, email, service type, bandwidth needs, and signature. The form also has a section for official use only which includes details of the assigned IP addresses, bandwidth type, activation date and signatures of the authorizing officer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    PAKISTAN TELECOMMUNICATION AUTHO

    HEAD QUARTER F-5/L ISLAMABAD


    http://www.pta.gov.pk

    Form No: _____________ Date: _____________


    Customer Detail (All the instruction to fill the form is overleaf)
    Customer Type: New Existing
    Name:_______________________________________________________
    Father Name: _________________________________________________
    CNIC (Attach Copy): __________________________________________
    Current Postal Address: ________________________________________
    ______________________________________________________________________________
    Address Where Service Required : __________________________________________________
    Phone (Land Line): ____________________ Fax: ____________________________
    Phone (res): __________________________ Mobile: _________________________
    Email: ______________________________ URL (if any): _____________________
    Service Type: Residential Corporate
    Service Description (Required Services): _____________________________________________
    Mode of BW Termination (Fiber, Wireless etc): _______________________________________
    Business of the applicant: _________________________________________________________
    Left Thumb Impression Right Thumb Impression

    Signature: ___________________________
    ______________________________________________________________________________
    Official Use Only
    Client Name: ___________________________________________________________________
    Assigned IP (S): Dynamic (Mention Ip Pools) Static (Mention IPS)
    ________________________________________________________________________

    Bandwidth Type: CIR Shared

    Other Services: ________________________________Activation Date: ___________________


    Installation Address (Where Applicable): ____________________________________________
    Billing Address: ________________________________________________________________

    Date: ______________ Signature (With official Stamp):_________________________

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