Address Verification Sheet.docx

Bulk Connection Request (BCR) Verification Sheet (Details to be filled by Channel & to be scrutinized by ASM/TSM) Name of the Organization: SHREEJA PACKAGES Name of the Authorized Person: KRISNAN.V Designation: PROPRATER Contact details: Mobile:+91 9524722434 Land line: Email :[email protected] Address: NO 1195 NTR NAGAR, RING ROAD, HOSUR.635126 Business Activity: FOAM PRODUCTS Address as per address proof document being submitted by customer (if different from above): __________________________________________________________________________________ __________________________________________________________________________________ Details of Mobiles numbers (If number of Rows exceeded, please use a separate sheet) Sl Mobile No Name of the User Designation Used at Location 1 9344422260 RAJASEKAR MANAGER HOSUR 2 9344422261 RANJITH CASHIER HOSUR 3 9344422262 SATHYA ACCOUNTSNT HOSUR 4 9344422263 SANKAR SUPERVISOR HOSUR 5 9344422267 MURUGSAN SUPERVISOR HOSUR 6 9344422291 KUMAR SUPERVISOR HOSUR 7 9344422268 SASI SUPERVISOR HOSUR 8 9344422253 CHANDIRAN SUPERVISOR HOSUR 9 9025077773 SAROJ SUPERVISOR HOSUR 10 11 12 13 14 15 16 17 18 19 20 ( To be filled only after completion of Bulk Verification Visit by Zonal Coordinator & TSM/ ASM) Record of Premises Verification by IDEA rep for Bonafide usage & not for VOIP or call routing business Business Activity of the customer Annual Turn Over in Lakhs Name & Details with design. of person contacted No of Employee Sited Availability and Type of Title / Name Board Declaration: Customer has been informed that in case of any changes in User name to be intimated to ICL within 7 days from the date of changes effected. It was also informed that Customer has to provide the user name details with designation in their letter headto ICL at every quarter or as on when the request has been raised by ICL.

Reviewed By : Date & Time of Visit Comments: Signature

Zonal Coordinator

TSM / ASM

ZBM