Designation. Staff No. Employee No./Hrms package No

Bharat Sanchar Nigam Limited

1. 
   Name of the officer (in block letter)
   
2. 
   Designation.
   
3. 
   Staff No.
   
4. 
   Employee No./HRMS Package No.
   
5. 
   Scale of Pay.
   
6. 
   Date of joining in BSNL C.O.
   
7. 
   Details of last mobile handset Re-imbursement/issued.
   

1. 
   Date of last reimbursement by BSNL.
   
2. 
   Name of unit where last re-imbursement done(Enclose Certficate).
   

3. 
   Date of last handset issued by BSNL.
   
4. 
   Name of unit where last handset issued.
   
5. 
   Date of superannuation.
   

I have been appointed/ promoted to present grade on regular/adhoc/local officiating basis and posted in BSNL Corporate office on (date) --------------------------------------------------as (designation) ---------------------------------on---------------------------------------vide order No.-

--------------------------------dated--------------------------(Copy of the posting /promotion order and copy of charge report are enclosed).

Neither any claim for cost of Mobile Handset has been preferred by me in any of the BSNL units nor a mobile handset has been issued to me by any of the BSNL units during the previous three years.

OR

It is certified that I have been allotted a GSM mobile handset of make ---------------------Model----------------on (date) ----------------------hence I am preferring this claim after expiry of the three years period from the date of issue/claim of the last handset (Delete whichever is not applicable).

Date:

Tele No.-------------------------

Encl: As above.

Bharat Sanchar Nigam Limited

• 
  Certificate that mobile handset mentioned in the claim was purchased for official use.
  
• 
  Certified that I have not submitted any other claim for the above purpose.
  
• 
  Self certified bill/ voucher is enclosed in original.
  
• 
  ERP claim printout is enclosed.