MAHANAGAR TELEPHONE NIGAM LIMITED, DELHI
(http://www.mtnl.net.in/download_forms/basic/surrender.htm)
FORM FOR SURRENDER OF CONNECTION

1. Telephone Number 
                    
2. Name of the customer /company/organization(surname first)
                                                                                            
3. Address where the telephone is working
Flat No.
           
Floor.
                    
Plot No.
                 
Building
                                                                                            
Street. 
                                            
Locality. 
                             
City. 
                                            
Pin. 
                       
4. Date on Which telephone is required to be Closed :  
                    
Reasons for Closure                            1.Taking all India shift
    (Please tick the appropriate Sl.No.)   2.Shift within Mumbai
                                                      3.This is an additional telephone
                                                      4.Financial/Economic                            
                                                        condition /closure of company /Business.
                                                      5.Tariff high
                                                      6.Surrender of OYT Connection as tele.Is 
                                                       available on demand.
                                                      7.Taking telephone from other company.
                                                      8.Not satisfied with service 
                                                          (a)Commercial
                                                           (b)Billing
                                                           (c)Any other reason
                                                      9.Any other reason (Pl.specify)

                                                        ____________________
                                                        ____________________
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After adjustment of outstanding bills, balance Security if any may please be refunded at the Address given below. I hereby undertake to pay any amount due to MTNL, which comes to the notice even at a later date and after closure of connection
Signature of Customer
Dated:______________

Address .        ______________
(if different from 3 above)______________
                                          ______________