To be filled by customer:

Customer name ______________________________________________________________________

Vodafone Number ___________________________________________________________________

OLD SIM CARD Number ________________________________________________________________

Relationship Number __________________________________________________________________

Alternate Contact Number ______________________________________________________________

Postpaid Prepaid

Reason for replacement of services:

Damaged Faulty Upgrade Lost

When was SIM lost? _________________________________________________________________________________________

Documents given:

Self attested Photo Id Proof

Self attested Address Proof

I have NOT given the old SIM card

I have given the old SIM card.

I have received new SIM card number_________________________________________________________________________

Customer’s Signature________________________________________________________________________________________

Name____________________________________________________________________________________________________

Date_____________________________________________________________________________________________________

NEW SIM CARD Number _____________________________________________________________________________________

SIM replacement cost (Rs.99)

Charge to Bill Cash/Credit Card Complimentary reason:______________________________

Verified by:

Commercial Officer’s signature________________________________________________________________

Commercial Officer’s name____________________________________________________________________________________

Store Executive’s signature ____________________________________________________________________________________

Store Executive’s name_______________________________________________________________________________________

SR number (Reactivation, if any)________________ SR number (Replacement)_______________

SIM Replacement Form

Subscriber Photograph

Paste OldSIM Card

Stamp byCommercial

Officer / VMS

Vodafone India Limited

CHECKLIST FOR USE AT VODAFONE STORE / MOBILE STORE / METRO STORE / MINISTORE

Checks by Exec. Comml. Officer

Nature of Original Id proof shown: ___________________________________________

Passport Pan card Driving License Voter Id card

Original Address proof shown: ______________________________________________

Photograph pasted (Optional)

Self attested Photocopy taken having Original signature (ORIGINAL Proof SEEN & VERIFIED)

OLD SIM card status

Activated Suspended Suspension Date: ________________

Over dues cleared

In case Suspended or Outgoing/Incoming barred (CRM overdue)

outstanding to be cleared

Authorisation Letter with Subscriber & Visitor Signature taken

Ownership Transferred in last 6 months: Yes or No

Billing address Transferred in last 6 months: Yes or No

In-roamer: Yes or No

Premium number: Yes or No

Verified by:

Commercial Officer/TL/TC/Floor Supervisor’s signature______________________________________________________________

Date_____________________________________________________________________________________________________

Commercial /TL/TC/Floor Supervisor’s name______________________________________________________________________

Checks:

Customer handed over old SIM card no.

Broken in two pieces and pasted it.

Customer DID NOT hand over the old SIM card.

New SIM card number received

TAT given hours

Time of issuing NEW SIM CARD hours

Verified by:

Store Executive’s signature ___________________________________________________________________________________

Date ____________________________________________________________________________________________________

Store Executive’s name ______________________________________________________________________________________