Caf Hyd
Caf Hyd
Caf Hyd
Vodafone no.
Affix recent passport
size photograph of applicant
SIM card no.
Please sign across, sign should
Have you ever subscribed to a Vodafone Postpaid connection? Yes (If yes, provide number/s) No overlap on photo and form
1. 2. Signa
ture
Cross
# Name (Mr/Ms/Dr/Prof)
First name Middle name Last name
# Father's/Husband's
Name (Mr/Dr/Prof)
First name Middle name Last name
# Mother’s Name
First name Middle name Last name
#
Gender Male Female Marital status Married Single #
Date of birth (dd/mm/yy)
City/Town Village
Email:
Office Address / Alternate Address
Company’s Name
Address
Email:
Permanent Address
Address
Customer declaration
I/We agree to pay the one time installation fee, refundable security deposit and all charges associated with the services selected by me/us. I/We have read and
fully understood the terms and conditions mentioned overleaf and unconditionally accept them as binding on me/us. I/We have understood all the rates, tariffs
and other related conditions at which telecommunications services will be provided inside and outside India as applicable as on this date and as amended from
time to time. I/We hereby undertake to pay all charges raised on account of Services availed. I/We undertake that in the event this connection is used for any
telemarketing purpose, I/We shall be solely responsible for registration of the connection with the mandated statutory authorities. I/We further declare and
Customer
Signature of the customer/
undertake that above information provided by me/us is true and correct in all respect.
Authorised signatory along with seal Date
Distributor declaration
Distributor
I/We hereby confirm that I/We have seen the customer and certify that (a) the customer enrolment form has been duly filled by the applicant, (b) the photograph
submitted has been matched with the applicant, (c) the form has been personally signed by the applicant in my presence, (d) proof of identity & address has been
collected, and (e) the original proof of identity & address has been matched and verified with the self attested documents submitted by the applicant. I/We
confirm(s) that the details on the documents are matching with those on the application. I/We further confirm that this application form is filled correctly and
completely in all respects by the customer. I/We undertakes that that the SIM card shall be activated only after due verification of all the necessary documents Name, signature and stamp
and information. I/We hereby confirm that I/We have tele-verified and/or cross verified the particulars furnished by the applicant with local reference and of the distributor Date
recorded its correctness.
Distributor / Vodafone Store code Executive Name Executive code Executive Contact No.
Provisioning executive Checked by
Time Date Customer Urban Rural
Remarks
Special instructions
*Note: Vodafone roaming without security deposit is available on your phone enabling you to roam across india on Vodafone networks in Vodafone circles and all networks in other circles.
# Your Vodafone SIM Card will be activated only if this information is complete. * You will need to provide at least one telephone number/address for your Vodafone SIM Card to be activated. If you do not have a telephone then both
addresses are required. • Details of packages, tariff plans and value added services are as set out in the tariff
information pamphlet at the Vodafone Store and all Vodafone authorised dealers. • For your records, do take a photocopy of the completely filled form.
Vodafone Essar South Limited, 6th floor, Varun Towers II, Begumpet, Hyderabad 500 016 M +91 98850 98850 www.vodafone.in