MAHANAGAR TELEPHONE NIGAM LIMITED,MUMBAI

APPLICATION FOR AVAILING SENIOR CITIZEN TELEPHONE CONNECTION (RENTAL TARIFF CONCESSION)

1. Name of Subscriber :
2. Address of Subscriber where :
telephone is working
3. Date of Birth :
4. Telephone Number : Tele. No. Sub’s Name
1)
2)
3)
4)
5)
5. Rental Tariff concession : No.
required on Tele. No.(Only
one tele. no. is eligible for
concession)
6. Documentary proof of Age or : 1) Identity Card
Date of birth issued by any 2) Driving Licence
Govt. Institution/Local Body 3) Passport
attached(tick any one & attach 4) Educational Certificate
the proof) 5) PAN
1) I hereby declare that I am a Senior Citizen aged 65 years and above,
and so far I have not applied for any Telephone Rental Concession for telephones
provided in my house/flat and also I shall not apply for telephone tariff concession
for other telephones provided to us except above mentioned telephone number.
2) I also declare that my Wife/Husband did not apply/avail rental concession
under Senior Category for any other telephone connection.
Date : Signature :
Name :
Encl : One document as ticked above is attached.