Internet Services Usage Declaration Form
Customer Name:
Installation Address:
Bandwidth (Kbps / Mbps / Gbps):
IP address block: . . .
Contact Person with details:
Name :
Tel. no.:
Are you a service provider (please tick): Yes No
If yes, please provide the following details
Type of service provider :
License Type :
License Number :
Validity till : Date of issue :
Network Diagram detailing the IP address deployment attached? Yes No
Internet Leased Line connection details
Termination device: Router Switch
Others (please specify)
Applications for which Internet will be used
Will Voice over Internet (VoIP) be used? Yes No
If Yes customer should agree to comply to the below mentioned points
a. Will use Voice over Internet as per the ITSP license which states Internet Telephony as a service to process and carry voice signals can be offered through
public Internet by use of Personal Computer (PC) or IP based Customer Premises Equipments (CPE) connecting the following only:
PC to PC; within or outside India
PC in India to Telephone outside India
IP based H.323 / SIP Terminals connected directly to ISP nodes to similar terminals; within or outside India.
b. Addressing scheme for Internet telephony shall only conform to IP Addressing Scheme of Internet Assigned Number Authority (IANA) exclusive of National
Numbering Scheme / plan applicable to subscribers of Basic/cellular telephone Service
Termination device details (Please tick one)
a. Voice gateway / Router with Analog Handsets
b. Voice gateway with PAX connectivity (Without any PSTN interconnection)
c. Direct termination from router to handsets
d. Soft Phone
e. IP Phone
Any other
As per the License obligations and conditions thereof I/We hereby agree for the prohibition of the under mentioned activities as part of Internet Telephony
a. Voice communication from anywhere to anywhere by means of dialing a telephone number (PSTN/ISDN/PLMN) as defined in National Numbering Plan is
not permitted
b. Originating the voice communication service from a Telephone in India is not permitted
c. Terminating the voice communication to Telephone within India is not permitted
d. Establishing connection to any Public Switched Network in India and/or establishing gateway between Internet & PSTN/ ISDN/PLMN in India is
not permitted
e. Any hardware/software which are identified as unlawful and/or render network security vulnerable shall not be used
f. Will not misuse the connection in any manner in violation of the law of land
I/We hereby give RailTel Corporation Of India Ltd and its Associates/Partners the right to:
a. Visit the Customer Premises and verify the validity of above stated information at anytime during the Service Contract Period unhindered and without
prior notice
b. Take corrective action in case of misuse of the Service or breach of any Applicable Law, which include but is not limited to blocking of
offending traffic, termination of Service after giving due notice and reporting the incident to appropriate Authorities