Form No. Com-12 BHARAT SANCHAR NIGAM LIMITED (A Govt.

of India Enterprise) CalcuttaTelephones APPLICATION FOR TRANSFER OF TELEPHONE 1. 2. Name of the subscribers Address at which the connection is working Telephone No(s) Type of telephone (OYT/NON OYT) Particulars of accessories such as extensions, PEX, etc. if any Name of the party to whom the occupation is going to be transferred Reasons of transfer Relationship between the present subscriber & transferee : :

3. 4. 5.

6.

7. 8.

: :

9.

In case of transfer on account of death of original hirer : : 1. i) Date of death : 2. ii) No. of legal heirs : 3. iii) Name of legal heirs
(including Widow/Widower) iv) is v) hirer left a will willing to accept. Whether the deceased Whether Widow/Widower

: 4. :

10.

Name (s) of the existing : 1. properties/Partners in case the subs. is a firm 2. 3. 4.

11.

Name(s) of proprietor & Partners after the transfer

: 1. 2. 3. 4.

I/We affirms that the above information is correct and that /those telephone(s) indicated above may be transferred to the party indicated at item No. 6 above. The relevant document prescribed is attached duly filled . I/We also declare that I/We shall not claim the telephone in future. Place : Date : Signature(s) of the transferor 1. ____________________________________ 2. ____________________________________ 3. ____________________________________ 4. ____________________________________ I/We hereby agree to accept the above telephone(s) and I/We agree to abide by the provision in the Indian Telegraph Rules, 1951 and I/We agree to pay all the dues against the telephone(s) including any pending dues pertaining to periods prior to the date of transfer. I/We further declare that I/We shall not ask for transfer of the telephone to another party within a period of three years. I/We indemnity the Department against future claim. Place : Date : Signature(s) of the transferee 1. ____________________________________ 2. ____________________________________ 3. ____________________________________ 4. ____________________________________

INSTRUCTIONS
1. The following documents should be sent along with the application for transfer : (A) In the event of death of hirer : (Application for transfer should be made within period of one year of death of hirer) i an attested copy of the will if the deceased has left a will. ii an attested copy of the power of attorney if the power of attorney is given to one of legal successors by the others to deal with the Department regarding telephone. iii if there are more than one legal heir, a letter of consent (in prescribed form) by all the other legal heirs agreeing to the transfer of telephone together with deposit amount if any to the claimant stating that they will not claim the telephone in future. iv in case the Widow/Widower of the deceased hirer is not alive or does not wish to retain the telephone in his/her name that should be clearly mentioned in the application. v an affidavit indicating the date of death and the names of all the legal heirs of the deceased subscribers is to be submitted by the transferor. (B) i an affidavit sworn by proprietor, if the transferee is a proprietary concern. an attested copy of Deed of Partnership, if the transferee is a partnership ii concern. copy of the Memorandum of articles of Association/Bye Laws, if the transferee iii is Company/Organisation. (C) i An indemnity Bond on Stamp paper in prescribed departmental form is required to all cases of transfer of OYT Telephones.

2. The transfer fee shall be RS. 100 -----------------