26 – 06 - 2007

BHARAT SANCHAR NIGAM LIMITED

CALCUTTA TELEPHONES
(http://www.bsnl.co.in/ or http://www.calcuttatelephones.com)
APPLICATION FORM FOR BROAD BAND SERVICE (DATA ONE)
(For existing BSNL customers only)

Existing BSNL Telephone No. on which Broad Band connection is required:

(Kindly enclose the copy of the latest telephone bill)
2

1. Title/Name of the Customer/Company/Firm/Organization (SURNAME FIRST)

2. Contact Tel No: :……………………………………Mob:………………………………………….Existing E- Mail address: __________@___________.

( Mandatory )
3. Modem Options: (See over leaf for tariff particulars – Table – 1)

a. Do you wish BSNL to Provide Modem? YES NO

b) If Yes, then please tick any one of the following options (i or ii or iii).
i) Option- i Outright Modem purchase from BSNL
(See table No. 2) Type
i) Option – ii Use BSNL Modem by Paying Advance Monthly Rental of
Rs 100/- & refundable Security Deposit of Rs. 500/-

ii) Option – iii ** Free Modem

** Opt for any of the following Tariff Plan and avail modem FREE.

Home Plan Business Plan

Plan Committed Period Please tick (√) here Plan Committed Period Please tick (√) here

Home 1800 12 Months Business 1200 18 Months

Home 3300 6 Months Business 3000 9 Months

Business 5000 6 Months

Business 9000 3 Months

II) If NO, the Modem used by you should be a standard ADSL Modem.

4. Tariff Options (*Tariff subject to change without notice)

(Please tick any one of the following and for instruction s see Table – 3 & 4 of ove rleaf )
A. Home:

250 500 UL 900 Plus UL 900 1000 1800 3300

Payment Option Monthly Annually

B.
C. B. Business:

700 1200 3000 5000 9000

Payment Option Monthly Annually

5. Choice for user id’s: i)………………………………………………………ii)………………………………………………………………iii)…………………………………………………

iv)……………………………………………… v)………………………………………………… vi)………………………………………………………………

Note: A For plan with one free e-mail id, 3 choices of user id (6 to 10 characters ) may be given.
User name is subject to availability.
(In case preferred user name is not available BSNL will provide one user name generated by the system)
………………………………………………………………………………..………………………………………………………………………………..…………………………………………………………………………………
Franchisee Code (if any ):

Signature of Customer/Authorised Signatory Signature of Customer/Authorised Signatory

 Contd…Page 2

TERMS AND CONDITIONS Page-2

Applicants are requested to read the following terms and conditions before signing the application for Broadband Internet:
GENERAL:
1. Application form is free of cost. The form may be filled up in capital letters only.
2. Subject to the acceptance of the application and technical feasibility BSNL will endeavour to provide the Broadband Service as soon as possible.
3. The contract with BSNL for provision of Broadband Service will be for a minimum period from the date of commencement (depending upon the
plan chosen) in accordance with the tariff plan opted.
4. The data rates shown as down streams or upstream is applicable only to last mile. However BSNL does not hold responsibility for lesser download
or upload data rates caused by the accessed website status or the international gateway or the media.
5. Customers are free to choose their own Modem of approved models .
6. All IP addresses assigned will be dynamic.
7. The Broadband connection is likely to be withdrawn in case the customer surrenders BSNL telephone lines.
8. Shifting of Broadband connection subject to the technical feasibility would be done on payment of the applicable shifting charges.
9. Home users will be able to connect only one computer to the Modem. In case of business users, it would be possible to connect more than one
computer depending on the plan opted for.
10. Each home user can get atleast one email account. User name as per the preference indicated by customer would be allocated subject to their
availability.
11. The subscriber is required to fully comply with the provisions of the Indian Telegraph Act 1885, Indian Telegraph Rules and the Information
Technology Act 2000 made there under and any amendments or replacements made thereto from time to time.
12. Conditions for providing Home plan or Business plan:-
(a) Either Plan can be offered to subscribers having telephones in individual names working at homes/residences used for personal purpose.
(b) Subscribers having telephones in the name of company, firms, shops, educational institutes or any other commercial entity can be given only
Business Plan. They are not eligible for Home Plan.
(c) Telephones working in individual names at commercial/business/office premises are also not entitled for Home Plans.
(d) Home plan can be given on bfones in the name of Government/company but actually working at residences of their employees. An
undertaking may be taken from the customer before providing the said connection.
PAYMENTS
At the time of issue of Demand Note, following charges will be collected.
a) Installation charges (As applicable). b) Advance Rental as per billing cycle (One month / Two months). c) Security deposit of the modem (If
Applicable). d) Advance monthly rental for modem. e) Refundable security deposit for 2 months rental as per the plan (As applicable).
f) Service Tax, as applicable, will be levied.
Other Conditions
a. For the DIAS customers, who are likely to switch to ADSL Broadband services, the transfer of Security Deposit to ADSL is permitted.
b. Billing for the service will be included in the normal b-fone bill. The billing cycle shall be same as b-fone billing cycle etc. Monthly rental
will be collected in advance and usage charges in arrears.
15. No migration is allowed to the lower tariff plan till the expiry of the committed period.
RIGHT TO TERMINATE SERVICE:
1. BSNL reserves the right to disconnect the service to any customer in case there is sufficient evidence of the customer intentionally or
unintentionally using the service in a manner which would adversely impact BSNL or BSNL’s Network.
2. The customer shall be responsible for using the service only for Legal and appropriate purposes
3. BSNL reserves the right to terminate the services in the event of non-payment of bills preferred by BSNL in accordance with the tariff plans opted
by the customer and the extent of usage or any default on the part of customers.
DISCLAIMER:
1. BSNL will exercise all reasonable care in providing its services, but it is not responsible for interruption/service due to power failures, equipment
malfunctions, or acts of natural calamity.
2. BSNL is not responsible for subscriber’s computer hardware and software or areas of the Internet not under its control. BSNL does not warrant
privacy, security, or efficiency of the Internet.
3. BSNL is not responsible for actions taken by its customers or others as a result of its services.
4. BSNL is not responsible for material any person (including household members of the subscriber) may receive or transmit via the Internet, or for
anything bought or sold via the Internet, or for any other result of an action taken by anyone using its service.

Place: Signature of the subscriber

Date:

Table 1. Modem Charges (For Filling up Details asked at SL NO – 3 of Application form)

Installation Charges Rs 250(In case of Modem from BSNL)

1. Alternate to Purchase of Modem
1. Monthly Rental Rs 100
2. Security Deposit (Refundable)
Rs 500

Shifting Charges NIL w.e.f 15.07.2005

Charge for Change of Plan NIL w.e.f. 09.06.2005
Table 2. Option for Modem for Outright purchase:-

Modem Type
Ports Type-I Type-II Type-III Type-IV
Ethernet One One Four Four
Wi-Fi -- One -- One
USB One -- -- --
Charges(RS) 1200 1800 1500 2000
Contd.......Page 3
 Page -3
Table 3. Tariff in Rs. (For Filling up Details asked at SL NO – 4A of Application form)

Particulars Tariff in Rs.

Home Home Home UL Home UL Home Home Home
900 Plus 900 3300
250(New) 500 1000 1800
Bandwidth 256Kbps 256Kbps/ 256Kbps 256Kbps 384Kbps/ 512Kbps/ 2Mbps
/ Upto Upto Upto Upto
2Mbps 2Mbps 2Mbps 2Mbps
Monthly Charges(Rs.) 250 500 900 900 1,000 1,800 3,300
Annual Payment Option to 2,500 5,000 9,000 9,000 10,000 18,000 33,000
Customers(Rs.)
Free data 1.0 GB 2.5 GB unlimited unlimited 5 GB 10 GB 20 GB
transfer(upload/download)(GB)
Additional Usage Charges/MB 0.90 0.80 Nil Not 0.80 0.70 0.70
Beyond free data transfer(Rs.) applicable
Free E-mail IDs/Space (Per E- 1/5 MB 1/5 MB 2/5 MB 2/5 MB 1/5 MB 1/5 MB 2/5 MB
mail ID)
Security Deposit NIL NIL 1 month 1 month 1 month 1 month 1 month
rental rental rental rental rental

Night Unlimited Not Available Not Not Available Available Available

Available applicable applicable
(02.00- 08.00 Hrs.)
Minimum Hire Period Three Three One One One One One
months months month month month month month
Telephone Rental per month As per As per Nil As per As per As per As per
existing existing existing existing existing existing
plan plan plan plan plan plan
Free Call As per As per Nil As per As per As per As per
existing existing existing existing existing existing
plan plan plan plan plan plan
MCU Charges /Pulse As per As per Rs. 1.00 As per As per As per As per
existing existing existing existing existing existing
plan plan plan plan plan plan

Table 4. Tariff in Rs. (For Filling up Details asked at SL NO – 4 B of Application form)

Particulars Tariff in Rs.

Business Business Business Business Business
700(New) 1200 3000 5000 9000
Bandwidth 256 256 512 1 Mbps/Upto 2 Mbps
Kbps/Upto Kbps/Upto Kbps/Upto 2Mbps
2Mbps 2Mbps 2Mbps
Single/Multi User(SU/MU) SU SU MU MU MU
Monthly Charges(Rs) 700 1,200 3,000 5,000 9,000
Annual Payment Option to Customers(Rs) 7,000 12,000 30,000 50,000 90,000
Free data transfer(upload/download)(GB) 4 GB 8 GB 20 GB 35 GB 75 GB
Additional Usage Charges/MB Beyond free 0.80 0.80 0.50 0.50 0.50
data transfer(Rs.)
Free E-mail IDs/Space(Per E-mail ID) 1/5 MB 1/5 MB 2/5 MB 2/5 MB 4/5 MB
Static IP address(On request) Not Available Not Available Not Available One One
Web hosting space(On request) Not available Not available Not available 5 MB 5 MB
Domain Name(On request) Not Available Not Not Available One One
Available
Security Deposit 1 Month 1 months 1 month 1 month Rs. 5000
rental rental rental rental
Minimum Hire Period One month One month One month One month One month

Note: * Registration Fee: Rs. 100/- * Service Taxes Extra

*** Under Ideal Usage Conditions