International Roaming Serial #

Subscription Form Postpaid

This part to be filled by subscriber (in English block letters)

GP Mobile Number 0 1 7
Individual/Company's Name

Billing Address

User's Name Date of Birth

Telephone E-mail

Tick (ü) any one

Passport No. Date of Issue Standard Roaming SMS Roaming

Nationality Date of Expiry Basic Roaming Data Roaming

For service related query, complaint & assistance: insta.service@grameenphone.com; For Roaming related queries, dial 121 or +8801700100121

For Corporate/Organizational Subscriber

Organizational Authorization
I hereby authorize the aforesaid mobile subscription owned by our organization to its user who is our employee for the purpose of availing International Roaming.
With this, I declare that all the bills/advances/securities will be settled from the International Credit Card of the user.

Signature of the Company Authorized Person Designation Company Seal

Bulk IR Registration
The Standard/Basic/SMS/Data Roaming have been activated in …………………….. (Number of SIM) as per attached Bulk IR Subscription Form (Form serial No. …………)
against……………………………………………..(name of the company/organization). I, on behalf of the company/organization take responsibility of these SIMs for
International Roaming service and hereby accept the terms and conditions written in International Roaming subscription form.

Signature of the Company Authorized Person Designation Company Seal

For Individual/Corporate Subscriber

I hereby declare that for the purpose of availing the service of International Roaming, I have no objection whatsoever using my personal International Credit Card
with aforesaid number for the payment of the bills incurred and also understand that any kind of refund/adjustment from Grameenphone will be settled within
account of the mobile number stated above. I also agree to abide by Bangladesh Bank’s rules & directives regarding International Roaming.
I authorize Grameenphone to debit my Int’l Credit Card/Debit Card Date of Expiry:
m m y y
for amount of Taka for Security deposit of International Roaming.

Full name of the user Signature of the user

Please preserve this document for future reference AbyMÖn K‡i `wjjwU fwel¨‡Zi Rb¨ msi¶Y Kiæb

This part to be filled by office

Signed Corp/SME Code Approval Code

i
Authorized GP Official's details POS ...............................................................................................

GP Official's Signature ID No. GP Official's Seal

Date

I hereby state that all the information given in this page are true and any changes thereof will be notified immediately to Grameenphone Ltd. I have read and
understood the terms & conditions provided overleaf and voluntarily accept them as binding on me and hereby sign this document.
 TERMS & CONDITIONS
(1) Grameenphone (GP) Xplore and Business Solutions postpaid subscriber may be eligible to avail GP
International Roaming service, provided he/she has an International Credit Card (subject to verification of the
card) that is valid and accepted by Grameenphone Ltd. and he/she never been permanently disconnected by GP
for IR related charges. Any directives issued by Bangladesh Bank (please visit www.bangladesh-bank.org)
authority regarding International Roaming or standing instruction will be applicable as default.
(2) Embassies, foreign missions, donor agencies, particular foreign firms, investors etc. will also qualify for
international Roaming service. Any directives issued by Bangladesh Bank (please visit
www.bangladesh-bank.org) authority regarding International Roaming or standing instruction will be applicable
as default.
(3) Diplomatic Mission (in Bangladesh) subscribers with designated convertible BDT accounts maintained under
Bangladesh Bank’s "GUIDELINES FOR FOREIGN EXCHANGE TRANSACTIONS", for updated information of Foreign
Exchange guidelines, visit www.bangladesh-bank.org
(4) All charges or bills will be collected from the subscriber in foreign currency against his/her International
Credit Card/Foreign currency accounts (if qualify), which is accepted by GP. All bills have to be settled in
Bangladesh on a monthly basis.
(5) Bangladesh national shall be required to deposit in foreign currency equivalent to Tk. 10,000( With auto
debit) or Tk. 20,000 (Without auto debit) as security deposit against his/her International Credit Card /foreign
currency account (if qualify) to avail GP Standard/Basic/Data Roaming service.
(6) Foreign national residing in Bangladesh shall be required to deposit in foreign currency equivalent to Tk.
10,000(With auto debit) or Tk. 50,000 (Without auto debit) as security deposit against his/her International
Credit Card/foreign currency account (if qualify) to avail GP Standard/Basic/Data Roaming service.
(7) The usage limit/credit limit for SMS roaming will be BDT. 1000 for subscribers who have 0 (Zero) security
deposit for SMS roaming. The subscriber can pay extra security deposit through his/her International
Debit/Credit Card (if qualify) for SMS roaming usage. The BDT. 1000 amount (credit limit over security deposit) is
applicable for both local and International Roaming usage.
(8) Grameenphone has the right to terminate or suspend the provision of the services to the subscriber if the
total charges (billed and to be billed) accumulated at any time exceed the subscriber's security deposit.
However, the subscriber has the option to increase his/her security deposit, by one or more slabs of Foreign
Currency equivalent to TK.5,000 through his/her International Credit Card/Foreign currency accounts (if qualify).
(9) To receive calls through Bangladesh while roaming, Grameenphone subscriber shall pay for all charges to
forward his/her calls from home network to visiting network. Local invoice will reflect the charges for that
forwarded ISD call as "Re-Routing-ISD Call" in BDT.
(10) For making and receiving calls within the visiting network, the subscriber shall pay all applicable charges of
the visiting network.
(11) As the charges or tariffs of different visited networks may change or differ at any time - it will be the
subscriber's responsibility to ascertain the details of the tariffs and charges from Grameenphone's Customer
Management Division before roaming. In case of any dispute with the "Visiting Network" regarding the bill and
services, GP shall not bear any responsibility therefor.
(12) The subscriber shall have to pay the home network's mark-up and/or any other charges applicable along
with the actual airtime charges.
(13) The subscriber shall have to pay Government Taxes, Levies, VAT, surcharges and other charges (if any)
applicable according to the Bangladesh Government's rules and regulations.
(14) The subscriber/user shall abide by the Bangladesh Bank's Foreign Exchange Regulations.
(15) If for any technical problem or any other problem occurring at the home network, visited network and/or in
the international circuit, it is not possible to render IR services, GP shall not be liable for it. Though GP would
strive to render best possible services.
(16) Grameenphone reserves the right to refuse providing or continuing service, terminate service. Nevertheless,
Grameenphone reserves the right to change the terms and conditions, all tariffs applicable to Grameenphone
outgoing Roaming facility without assigning any reason whatsoever.
(17) The payment procedure of the International Roaming bill shall be communicated to the subscriber by GP
while subscribing and as on when any changes are made to these procedures. The International Roaming
payment procedure, as implemented, are as per Bangladesh Bank Foreign Exchange Regulation and service
offered by the concerned International Credit Card/Foreign currency accounts (if qualify) issuing
Bank(s)/Authority(s). The payment procedure, as determined and communicated to the subscribers by GP, shall
be binding upon them.
(18) The International Roaming subscriber shall have to keep sufficient balance in his/her card account for
payment of the International Roaming bill before and after availing the roaming service.
(19) Grameenphone has the right to check the subscriber's International Credit Card status, International Credit
Card balance and block any balance from the card for security reasons.
(20) The International Roaming subscriber shall be responsible for selecting the appropriate handset for using
international roaming facility in the visiting networks. Subscribers can have additional information on this from
GP Customer Management Division (CMD).
(21) if a subscription is lost or stolen, Grameenphone will not be responsible for the lost or stolen phone or any
subsequent fraudulent use of the mobile phone/SIM card. In case of lost SIM, the subscriber must immediately
fax a written request to GP entailing account ID, mobile number and signature as on the subscription form to
suspend/bar his/her subscription.
(22) GP International Roaming Application form will be considered as a supplementary document of
Grameenphone's Application form. All terms and conditions of both shall therefore be applicable to the user of
GP "International Roaming Services."
(23) "International Roaming service will be activated subject to signature verification. GP will not be liable if the
International Roaming service is not activated due to mismatch of signature with the original subscription form."
(24) IR subscriber(s) are requested to preserve this form, if it is lost in any way, the subscriber must lodge a GD
(General Diary) with the concerned Police Station and communicate the same to GP for future reference and
availing customer service.
(25) Resonsibilities of GP are explicitly stated in this agreement as above and GP takes no other responsibilities
besides this.
(26) IR bill is charged based on the charging record that roaming partners claim/send. It could take up to three
months from your overseas return for the last roaming charges to appear on your Grameenphone bill.
(27) IR bill may cross the customer’s given limit and may not be bar as we received the billing records from
roaming partners for customers in bulk and in delayed time.
(28) If you are a Smartphone user, in that case various software or application on your Smartphone may initiate
data sessions automatically. For example it may check for new updates or email on a frequent basis. This may
incur higher data usage and additional high roaming cost unknown to you. To avoid this, you may disable data
service.
EDGE/GPRS based service will be charged according to roaming tariff and customers
should be aware of this. Before leaving for roaming, the subscriber should check it.
Date/ZvwiL Subscriber’s Signature/MÖvn‡Ki ¯^v¶i | Stamp/Seal (If company) ó¨v¤ú/mxj (†Kv¤úvbxi †¶‡Î)
kZ© I wbqgvejx
(1) MÖvgxY‡dv‡bi †mBme Xplore Ges Buiseness Solutions wcÖ‡cBW MÖvnK wRwc B›Uvib¨vkbvj †ivwgs mvwf©m
e¨envi Ki‡Z cvi‡eb hv‡`i Kv‡Q ˆea B›Uvib¨vkbvj †µwWU KvW© Av‡Q hv MÖvgxY‡dvb wjt Gi Kv‡Q MÖnY‡hvM¨ Ges hv‡`i
†gvevBj ms‡hvM wej ev †ivwgs PvR© msµvšÍ Kvi‡Y KLbB wew”Qbœ Kiv nqwb| GQvov memg‡qi Rb¨B, B›Uvib¨vkbvj †ivwgs
wel‡q evsjv‡`k e¨vsK KZ…©K cÖYxZ me ai‡bi bxwZgvjv ev Zvr¶wYK wb‡`©kbv cÖ‡hvR¨ n‡e (we¯ÍvwiZ Rvb‡Z wfwRU Kiæb
www.bangladesh-bank.org)
(2) G‡¤^wm, d‡ib wgkb, `vZv ms¯’v, wbw`©ó d‡ib dvg©, wewb‡qvMKvix BZ¨vw` ms¯’v¸‡jvI GB B›Uvib¨vkbvj †ivwgs mvwf©m
wb‡Z cvi‡e| (wfwRU Kiæb www.bangladesh-bank.org)
(3) evsjv‡`‡k Ae¯’vbiZ K~U‰bwZK wgkb Gi MÖvnKiv evsjv‡`k e¨vsK Gi ÔÔd‡ib G·‡PÄ UªvÄvKkb bxwZgvjvÓ Gi
Aax‡b B›Uvib¨vkbvj †ivwgs mvwf©m e¨envi Ki‡Z cv‡ib|
(4) mKj PvR© I wej MÖvgxY‡dv‡bi Kv‡Q MÖnY‡hvM¨ AvšÍR©vwZK †µwWU Kv‡W©i A_ev ˆe‡`wkK gy`ªv GKvD›U
(†hvM¨ we‡ewPZ n‡j) gva¨‡g ‰e‡`wkK gy`ªvq cÖ`vY Ki‡Z n‡e| mKj wej gvwmK wfwˇZ evsjv‡`‡k cwi‡kva Ki‡Z n‡e|
(5) evsjv‡`‡ki bvMwiK‡`i MÖvgxY‡dv‡bi ÷¨vÛvW©/†ewmK/WvUv AvšÍR©vwZK †ivwgs myweav MÖn‡Yi Rb¨ 10,000 UvKv
(A‡Uv †WweU mn) A_ev 20,000 UvKvi (A‡Uv †WweU Qvov) mgg~‡j¨i ˆe‡`wkK gy`ªv wbivcËv RvgvbZ wnmv‡e AvšÍR©vwZK
†µwWU KvW© A_ev ˆe‡`wkK gy`ªvi A¨vKvD›U (†hvM¨ we‡ewPZ n‡j) Gi gva¨‡g Rgv w`‡Z n‡e|
(6) evsjv‡`‡ki emevmKvwi we‡`kx bvMwiK‡`i MÖvgxY‡dv‡bi †ewmK/÷¨vÛvW©/WvUv AvšÍR©vwZK †ivwgs myweav MÖn‡Yi Rb¨
10,000 UvKv (A‡Uv †WweU mn) A_ev 50,000 (A‡Uv †WweU Qvov) UvKvi mgg~‡j¨i ˆe‡`wkK gy`ªv wbivcËv RvgvbZ
wnmv‡e AvšÍR©vwZK †µwWU KvW© A_ev ˆe‡`wkK gy`ªvi A¨vKvD›U (†hvM¨ we‡ewPZ n‡j) Gi gva¨‡g Rgv w`‡Z n‡e|
(7) 0 (k~Y¨) wbivcËv Rvgvb‡Zi GmGgGm †ivwgs MÖvn‡Kiv 1000 UvKv e¨envi mxgv cv‡eb| MÖvn‡Kiv GmGgGm †ivwgs
Gi e¨env‡ii Rb¨ Zv‡`i AvšÍR©vwZK †µwWU KvW© A_ev ˆe‡`wkK gy`ªv G¨vKvD›U (†hvM¨ we‡ewPZ n‡j) Gi gva¨‡g AwZwi³
wbivcËv RvgvbZ cwi‡kva Ki‡Z cv‡ib| wbivcËv Rvgvb‡Zi AwZwi³ e¨envi mxgv 1000 UvKv †jvKvj Ges AvšÍR©vwZK
†ivwgs Df‡qi e¨env‡ii †¶‡ÎB cÖ‡hvR¨ n‡e|
(8) MÖvn‡Ki eZ©gvb wej wKsev e¨envi K‡i‡Qb wKš‘ wej nqwb Gi cwigvY hw` Zvi wbivcËv Rvgvb‡Zi cwigvY AwZµg
K‡i, Zvn‡j MÖvgxY‡dvb †mB MÖvn‡Ki ms‡hvM ¯’wMZ ev mvgwqKfv‡e wew”Qbœ Ki‡Z cvi‡e| Z‡e MÖvnKiv †¯^”Qvq Zv‡`i
AvšÍR©vwZK †µwWU KvW© A_ev ˆe‡`wkK gy`ªv GKvD›U (†hvM¨ we‡ewPZ n‡j) gva¨‡g 5,000 UvKvi mgg~‡j¨i ˆe‡`wkK
gy`ªvi ¸wYZ‡K Zvi wbivcËv RvgvbZ e„w× Ki‡Z cvi‡eb|
(9) we‡`‡k †ivwgs Kivi mg‡q evsjv‡`k n‡q ¯’vbvšÍiK…Z †Kvb Kj MÖnY (wiwmf) Kivi †¶‡Î evsjv‡`k †_‡K H
†bUIqvK© ch©šÍ Kj d‡ivqvW© (¯’vbvšÍi) Kivi mg¯Í PvR© MÖvnK cÖ`vb Ki‡eb| GB AvBGmwW K‡ji PvR© †jvKvj we‡j
Òwi-iæwUs AvBGmwW KjÓ wn‡m‡e UvKvq cÖ`wk©Z n‡e|
(10) wfwRwUs †bUIqvK©-G Ae¯’v‡bi mg‡q Kj †cÖiY I MÖnY Ki‡j, MÖvnK‡K wfwRwUs †bUIqvK©-Gi mKj cÖ‡hvR¨ PvR©
cÖ`vb Ki‡Z n‡e|
(11) †h‡nZz wfwR‡UW †bUIqvK© Acv‡iUi‡`i U¨vwid ev g~j¨ †h‡Kvb mg‡q cwiewZ©Z n‡Z cv‡i, MÖvnKiv †ivwgs Kivi c~‡e©B
wbR `vwq‡Z¡ we¯ÍvwiZfv‡e g~j¨ ZvwjKv I Ab¨vb¨ PvR© MÖvgxY‡dv‡bi MÖvnK e¨e¯’vcbv wefvM †_‡K †R‡b wb‡eb| †Kvb
Ae¯’v‡ZB wfwRwUs †bUIqv‡K©i mwnZ wej ev †mev msµvšÍ †Kvb Awf‡hv‡Mi wel‡q MÖvgxY‡dvb †Kvb `vwqZ¡fvi enb Ki‡e bv|
(12) MÖvnK‡`i‡K GqviUvBg g~‡j¨i mv‡_ †nvg †bUIqv‡K©i gvK©Avc I Ab¨vb¨ cÖ‡hvR¨ PvR© w`‡Z n‡e|
(13) MÖvnK‡`i‡K wewa‡gvZv‡eK miKvi KZ…©K Av‡ivwcZ U¨v·, †jfx, f¨vU, mviPvR© I Ab¨vb¨ PvR© (hw` _v‡K) cÖ`vb
Ki‡Z n‡e|
(14) MÖvnK/e¨enviKvix‡`i‡K evsjv‡`k e¨vsK KZ…©K Av‡ivwcZ ˆe‡`wkK gy`ªv wbqš¿Y AvBb †g‡b Pj‡Z n‡e|
(15) †nvg †bUIqvK©, wfwR‡UW †bUIqvK© Ges/ev AvšÍR©vwZK mvwK©‡U †Kvb hvwš¿K ÎæwUi Kvi‡Y †mev `vb m¤¢e bv n‡j
Z¾b¨ MÖvgxY‡dvb `vqx _vK‡e bv| Z`m‡Ë¡I wRwc m‡e©v”P †mev cÖ`v‡b m‡Pó _vK‡e|
(16) MÖvgxY‡dvb †Kvb KviY `k©v‡bv e¨wZ‡i‡K mKj †mev cÖ`vb A_ev Pvjy ivL‡Z A¯^xK…wZ Rvbv‡bv I †mev cÖ`vb wew”Qbœ
Kivi AwaKvi msi¶Y K‡i| GQvovI MÖvgxY‡dvb Zvi mKj kZ© I wbqgvejx, †mev, U¨vwid/g~j¨, we‡kl K‡i MÖvgxY‡dvb
AvšÍR©vwZK †ivwgs myweavi †¶‡Î cÖ‡hvR¨ mKj U¨vwid, †Kvb KviY `kv©‡bv e¨wZ‡i‡K cwieZ©b Ki‡Z cvi‡e|
(17) AvšÍR©vwZK †ivwgs wej cwi‡kva cÖwµqv AvšÍR©vwZK †ivwgs mvwf©‡mi MÖvnK nevi mgq Ges cieZ©x‡Z GB cÖwµqv †Kvb
cwieZ©b n‡j MÖvnK‡K Zv Rvbv‡bv n‡e| AvšÍR©vwZK †ivwgs mvwf©‡mi wej cwi‡kva cÖwµqv evsjv‡`k e¨vs‡Ki ˆe‡`wkK gy`ªv
wewagvjv Ges mswkó AvšÍR©vwZK †µwWU KvW© cÖ`vbKvix e¨vsK/KZ©„c‡¶i cÖ`Ë mvwf©m Abyhvqx cÖYqb Kiv n‡q‡Q|
MÖvgxY‡dvb cÖYxZ I cÖÁvwcZ GB wej cwi‡kva cÖwµqv AvšÍR©vwZK †ivwgs mvwf©‡mi MÖvnKiv †g‡b Pj‡Z eva¨ _vK‡eb|
(18) MÖvnK‡K AvšÍR©vwZK †ivwgs mvwf©m MÖn‡Yi ci Ges wej cÖ`v‡bi Av‡M Zvi †µwWU KvW© A_ev ˆe‡`wkK gy`ªv GKvD›U
(†hvM¨ we‡ewPZ n‡j) AbyK‚‡j ch©vß UvKv Rgv ivL‡Z n‡e|
(19) MÖvgxY‡dvb wbivcËvi ¯^v‡_© MÖvnK‡`i AvšÍR©vwZK †µwWU KvW© Gi Ae¯’v, e¨vjvÝ Ges †h‡Kvb cwigvY UvKv
cix¶v-wbix¶v ev eÜ Kivi AwaKvi msi¶Y K‡i|
(20) wfwRwUs †bUIqv‡K© †ivwgs myweav cvevi Rb¨ h‡_vchy³ n¨vÛ‡mU evQvB Kivi `vwqZ¡ AvšÍR©vwZK †ivwgs MÖvnK‡`i|
MÖvnKiv wRwc MÖvnK e¨e¯’vcbv wefvM (Kv÷gvi g¨v‡bR‡g›U wWwfkb) n‡Z G m¤ú‡K© we¯ÍvwiZ Z_¨ †c‡Z cv‡ib|
(21) MÖvn‡Ki †dvb nvwi‡q †M‡j, Pzwi n‡j A_ev cÖZviYvg~jK Kv‡R e¨eüZ n‡j MÖvgxY‡dvb `vqx _vK‡e bv| †dvb nvwi‡q
†M‡j A_ev Pzwi n‡q hvevi mv‡_ mv‡_ MÖvnK‡K Zvi GKvD›U AvBwW, †gvevBj b¤^i Ges h_vh_ ¯^v¶i (mvew¯Œckb d‡g©i
Abyiƒc) mn wjwLZfv‡e d¨v· K†i H †dvb ¯’wMZ/evi Kivi Rb¨ wjwLZfv‡e Aby‡iva Ki‡Z n‡e|
(22) MÖvgxY‡dv‡bi AvšÍR©vwZK †ivwgs A¨vwcøKkb dg©, MÖvgxY‡dvb A¨vwcøKkb (Av‡e`b) d‡g©i cwic~iK wn‡m‡e cwiMwYZ
n‡e| Dfq d‡g©i mKj kZ© I wbqgvejx AvšÍR©vwZK †ivwgs mvwf©m e¨enviKvix‡`i †¶‡Î cÖ‡hvR¨ n‡e|
(23) ¯^v¶i hvPvB‡qi c‡iB ïaygvÎ AvšÍR©vwZK †ivwgs myweav Pvjy n‡e| g~j MÖvnK Kwci m‡_ ¯^v¶‡ii cv_©‡K¨i Kvi‡Y
†ivwgs myweav Pvjy bv n‡j MÖvgxY‡dvb `vqx _vK‡e bv|
(24) GB MÖvnK KwcwU msi¶Y Kivi Rb¨ MÖvnK‡`i we‡klfv‡e Aby‡iva Kiv hv‡”Q| †Kvb Kvi‡Y nvwi‡q †M‡j wbKU¯’ _vbvq
mvaviY Wv‡qix (wRwW) `v‡qic~eK
© cieZx© †h‡Kvb †mev MÖn‡Yi †¶‡Î D³ wRwWi Kwc MÖvgxY‡dvb‡K cÖ`vb Ki‡Z n‡e|
(25) †h mKj `vq-`vwq‡Z¡i K_v cwi¯‹vifv‡e GB Pzw³‡Z ewY©Z n‡jv G¸‡jv Qvov Ab¨ †Kvb `vq-`vwqZ¡ wRwci Dci
eZ©v‡e bv|
(26) †ivwgs wej PvR© Kiv nq g~jZ †ivwgs cvU©bvi‡`i `vex Kiv PvR© †iK‡W©i wfwˇZ| ZvB Avcbvi MÖvgxY‡dvb ms‡hv‡M
†gvU †ivwgs we‡ji cwigvY Rvb‡Z †`‡k †divi ci †_‡K mvaviYZ 3 gvm ch©šÍ mgq jv‡M|
(27) †h‡nZz Avgv‡`i †ivwgs cvU©bvi‡`i KvQ †_‡K †ivwgs we‡ji †iKW© †c‡Z wKQzUv mgq jv‡M, ZvB MÖvnK‡K †`Iqv
†ivwgs we‡ji wbw`©ó mxgv AwZµg Ki‡jI, ms‡hvM wew”Qbœ bvÕI n‡Z cv‡i|
(28) Avcwb hw` ¯§vU©‡dvb BDRvi †nvb, †m‡¶‡Î Avcbvi †dv‡b _vKv wewfbœ mdUIq¨vi ev A¨vwcø‡Kkb ¯^qswµqfv‡e WvUv
†mkb Ki‡Z cv‡i| †hgb GwU wbqwgZfv‡e bZzb bZzb Avc‡WU ev B‡gBj †PK Ki‡Z cv‡i| Gfv‡e A‡bK †ewk WvUv
BD‡m‡Ri m¤¢vebv _v‡K hv Avcbvi ARv‡šÍ evowZ †ivwgs Li‡Pi KviY n‡q `uvov‡Z cv‡i| ZvB GwU Gov‡Z WvUv mvwf©mwU
mvgwqKfv‡e wbw¯Œq ivL‡Z cv‡ib|
EDGE/GPRS wfwËK mvwf©m¸‡jvi Rb¨ †ivwgs U¨vwid Abyhvqx PvR© cÖ‡hvR¨ n‡e Ges MÖvnK‡K G e¨vcv‡i Aek¨B
m‡PZb _vK‡Z n‡e| †ivwgs-G hvIqvi Av‡M MÖvnK‡K Aek¨B GwU †`‡L wb‡Z n‡e|
Date/ZvwiL Seller's Signature and Seal/ we‡µZvi ¯^v¶i Ges mxj
IR Postpaid Form/October' 14