Myanma Posts and Telecommunications Information Technology Department ADSL Application Form

(1) Customer Information Customers Name Companys Name Address NRC No. Co., Registration No. Telephone No. Fax No. Contact Name Address Telephone No. Fax No. Government Private / Local Co., Embassy Foreign Co., / NGO Others Service

Documents Required for companies

Documents Required for Individuals Copy of NRC card

Company Registration Copy [Form (6) & Form (26) Copy]

(2) ADSL Services Requested Telephone No. Class of Speed e.mail Domain Name e.mail Address Area Code (A)512 Kbps (B)1.0 Mbps

Number (C)1.5 Mbps (D)2.0 Mbps (E)2.5Mbps

@mptmail.net.mm Option (1) Option (2) Option (3) Option (4)

@mptmail.com.mm Password Password Password Password Static Password Password

Type of Service (If Dynamic ) User Name

Dynamic Option(1) Option(2)

(3) Declaration : We / I hereby understand the ADSL service plan and installation charges . We / I confirm that the above information are correct and as per our desire . We / I also acknowledge and confirm that we have read and understood all terms and conditions related to MPT ADSL service mentioned in the contract and we unconditionally agree to be bounded by these terms and conditions . Applicants Name (4) Office Use Telephone No F Name Exchange Name NF Signature RSU Name NS Date Signature Date