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Gwave Subscription Form 2020

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0% found this document useful (0 votes)
68 views2 pages

Gwave Subscription Form 2020

Uploaded by

R
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
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SUBSCRIPTION FORM cwst No: 013500 GWave ao Subscriber's Name OM. /Ms. Omi ‘Contact PereoniUser Designation Please Ax Passport Size Photograph (OO NOT STAPLE) Date of Bich PAN No, Marital Status © Married © Single Fathers/Husband's Name - Nationalty Existing/Old Servico Provider.. ‘Spoken languages at home. Recent Bill attached © Yes ONO City Landmark Mobite No, FEE Nae E-mal ID. OHome 0 Gorporata) (OCombo Pian O United ) Port Speed. Proposed Usage J Month nna MB Services 2 3. No. of Static IPs eae ‘Amount Payable Rs... (in words) ‘Mode of Payment 0 Cash oICheque No| (© Debivcredit Card. Cash Receipt No. Bank .. Branch, cara No| (OMaster Card © Vise O.Others Expiry Date “Ihave read, understood thatthe Service(s), pte by me, as above, shall be provided in accordance wih ‘he tems and condone merltonod oveia” anc a3 pubishes mt waew qwave ersotste und ‘roe fabs by than. hal ba slay sponsible oral peymonts tars my subserfton() Subscriber's Signature Date. Ee a ea ee ee eis ed Perk eee ee) Reena iE mertcny arti ferent a en Te} Gwave Operations Centro eta een Pee eaten wc aC eo caine SS eee Seer Scownwnampcters «|| Seaematineeeetiaoemeeaaamas eon ‘Separate tt ere eta gets one taney neem etiam

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