You are on page 1of 1
All India Reporter Pvt. Ltd. NAGPUR - 440012, (M.S.) Congress N REP. COPY ORDER FORM ‘@ : 2434321 Fax No. (0712) 2426283 1. Please supply the following Books by VPP/ Regd. Book Post / Book Post (UCP) / ADS/Transport towards advance paid through Cash/Cheque*/ Amount of Rs..... DD No. No... Dr. Dr-, .. vide Provisional Receipt “For Outstation cheque please add Rs. 50/- towards Bank Collection Charges. Conditions given over Date :- NAME anears) | | | “t Publication’ fF Price Discount | Net Payable | | | | TOTAL ADVANCE BALANCE 2. ne have caretly gone tough the Nols end aso the terms and f. Wie hereby agree to the same. 3. IWe have received a copy ofthis order for my personal record and reference LT] {| | SIGNATURE OF SUBSCRIBER Lt] | L{ | | | * Party is )) New Subseriber (To be filed by Representative ) ADDRESS :- REP ji) Re-enrolled Id/Subscription No. TOWN PIN DISTRICT STATE PHONE Mobile No * Tick what is applicable E-mail Ot. of Birth FOR OFFICE USEONLY __TO BE FILLED BY OPERATOR AGENCY SECTION mi. Code Ord. No. Counter Despatch ‘Order Noted in Id. No Ord. Date Arranged for Agency on Indnt. Code | Sub. Catg, ‘Agent Code [ Ord. Catg. Desp. Mode No. of Copies

You might also like