DMS (Existing LINK SHIFTING & OLD LINK TERMINATION Request)

This is to certify that the DMS needs to be shifted at the new site as per the details mentioned below

*Mandatory field
Dealer Code* KA01
For Code* KA01021
Outlet Code
Tin No.*
Location Type ( S/2S/3S )*
Dealer Name* NEMA AUTO SPARES
No 86 , N V Gardens, Next to VIBGYOR School,Jayanthinagar Main
New Address*
Road, Jayanthinagar, Horamavu, Banagalore - 560 043
City* Bangalore
Pin Code* 560 043
State* Karnataka
Region* South
Zone* S2
Existing Link will be Terminated when New Link Delivered Successfully at New Location
Old Service Provider AIRTEL
Old Circuit ID 209326
Old Dealer Code KA01
Old Location Type DISTRIBUTOR
NO 8 , Near Ramamurthynagar Police Station,
Old Address* Vijinapura,Dooravaninagar Post, Ramamurthynagar ,Bangalore -
560016
Contact Person* RAM VITTAL
Desig CEO
Mobile No* 9945716141
Email Id vittalnema@gmail.com
CEO Name* RAM VITTAL

CEO Signature

Mobile No* 9945716141

Email Id vittalnema@gmail.com
Expected Date for site ready 01-Jul-20
Expected Activation Date 10-Jul-20
Expected Sales volume / Service Load per month
New Site to be linked with (LL/BB) Leased Line
Proposed Bandwidth Size 128 Kbps

Name of DD1 HO Coordinator/Mobile No.

Name of DMS Regional Coordinator/Mobile No. Mr. Kingsly Jose
Rollout for new sites to be initiated by concerned department and henceforth to be approved jointly by DMS, ITD
and SALES/ SERVICE based on the type of locations

Approved by : RM/RSM/RPM/DD1 Approved by : DMS Dept.

Name : Name :

Signature
Signature
Dept/Div Dept/Div : DMS/DDEV

FOR ITD USE

Forwarded Date to Service Provider

FOR HP USE
Date Of Receiving
Received By

Classification : Internal