Customer Acceptance Form Receipt

Receipt Number: 578913

Date: 03/14/2011

Dear Subscriber,
Tikona Digital Networks Pvt. Ltd. confirms the receipt of your Subscriber Registration form (SRF) as per the particulars
mentioned below.

Subscription Details Payment Details

SRF Number 50000011253286 # Payment Amount Details Date
Name BANDAPPA DHANASHRI Method (Rs.)
Mobile Number 9768358759 1 Cheque 1102 SDC 03/14/2011
Email Address shiv.viresh@gmail.com BANK,
Address for Installation 326917
Flat No 11 Important Information you should know
Building Name PRASHANT NIWAS Customer Account Number 114776984
BANDREKAR WADI RAM Billing Account Number 114723438
NAGAR Service ID 1103413397
Street/Area Name Jogeshwari (E) TikonaCARE Numbers 1800 - 20 - W I B R O
City Mumbai Toll free 1800 - 20 - 9 4 2 7 6
State MH (020) 6649 3000
Pin 400060

Service Details
# Product Type
1 CB499 Data Plan
2 VAS-AntiVirus-Basic-Monthly VAS Product LDAP
3 CPE BB Modem
Important Instructions
1. Please note your Service ID carefully. You will need it to log-in to Wi-Bro service for the first time.
2. For the subsequent log-ins, you may use the same Service ID or create an ALIAS of your choice
3. Your Password (Activation Key) will be sent separately on the mobile number mentioned in this receipt.
4. Please quote your Service ID for any further communication related to this service with Tikona.
5. If any information is incorrectly reflected in this receipt, please contact TikonaCARE.
6. This is an electronically generated document and hence does not require signature.