Please write in BLOCK LETTERS

Serial No.

Ref. CRF #

Customer Details:  
* *
  ( )
Hosting: ( )          
Charges Details:  
One Time Charges  
Service/Equipment Cost GST 15% Others Total
Installation Charges        
ONT Charges        
CPE Charges        
Other Charges (if any)        
Security (Refundable)        
VAS Charges        
Monthly Charges  
Services Internet Data Metro Last Mile Voice Others Total
Monthly Package Cost
(Payable in Advance)
Customer’s Declaration:
I hereby undertake and commit not to transfer/handover/sublet my FTTU/FTTH connection (even temporarily) to any person who may attempt to use it for any unlawful activity as described in Terms & Conditions. If I do so, I will be liable and fully responsible for all obligations under the law and ConnecTel will NOT be responsible. Any unauthorized transfer/use of the connection shall entitle ConnecTel to terminate my connection forthwith. I hereby certify that the information given in this form is correct. I have read and agreed to the Terms & Conditions of this agreement as stated on the reverse side. I undertake that the service provided by ConnecTel would not be used contrary the provisions of Pakistan Telecommunication (Reorganization) (Amendment) Act, 2005 and Pakistan Electronic Media Regulatory Authority Ordinace, 2002. If such is the case, ConnecTel has the right to disconnect my service immediately without any notice.
Date   Customer’s Signature  
For office use only
User Name allocated   Telephone # allocated  
Sales Representative   Sales Manager  
This service is to be used within Pakistan Gujranwala region code (055) only. The company reserves the right to disconnect the services without
giving notice or assigning any reason if the user is found violating the terms and conditions of the service agreement.
I accept the Terms & Conditions
141-143 Maulana Shaukat Ali Road, Lahore, Pakistan
Office Tel: +92 42 3517 1070-71, +92 42 32530100-04, Sales Tel: +92 42 32530100-04
Email:, Website: