Standard Mobile Porting Application Form by robertalai

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This is the Standard Mobile Number Porting Application form in Kenya

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									  NUMBER PORTING REQUEST FORM / FOMU YA OMBI LA KUBADILI MTANDAO




          MOBILE NUMBER PORTING REQUEST FORM / FOMU YA OMBI LA KUBADILI MTANDAO BILA KUBADILISHA NAMBARI YA SIMU


  SUBSCRIBERS DETAILS / MAELEZO KUMHUSU MTEJA

Customer Name* / Jina la Mteja ................................................................................................................................................................................
(Letter of Authority to be attached if necessary / Barua ya idhini kuambatanishwa iwapo itahitajika)
Postal Address / Sanduku la Posta ...........................................................................................................................................................................
Contact Telephone* / Nambari ya simu* ....................................................................................................................................................................
Email / Anwani ya barua pepe ...................................................................................................................................................................................

  PORTING DETAILS / MAELEZO YA KUBADILISHA

Number(s) to be ported* / Nambari zinazo/inayo badilishwa* ...................................................................................................................................
(separate sheet may be used for multiple numbers / Kwa nambari nyingi zaidi karatasi lingine kando laweza kutumika)
Number for SMS check* / Nambari ya kutazama SMS* ............................................................................................................................................
Name of current operator* / Jina la mtoaji huduma wa sasa .....................................................................................................................................
Tick where applicable / Weka alama panapohitajika
Current Account type* /                    PrePay                       PostPay
Aina ya akaunti ya sasa*                                               (Copy of the latest PostPay bill required / Nakala ya bili ya sasa ya PostPay inahitajika)

Type of account to be ported to* / Aina ya akaunti inayotarajiwa                                               PrePay                         PostPay

Porting date* /                                                           Town/City where this Porting request is made* /
Tarehe ya kubadilisha ................................................... Mji/Jiji ambako ombi la kubadilisha limefanywa* ................................................................

  *I declare that the information given is correct. As the owner / duly authorised agent of the owner of the number(s) to be ported, I appoint
   SAFARICOM to close my account with my current operator and to port my number(s).
  Further that,
  1. I understand that any unused top-up balance shall be lost;
  2. I have taken the necessary actions to retrieve any funds in my Mobile Money Transfer Account held against the number(s) to be ported;
  3. I understand that the porting request shall be rejected for non-payment of moneys owed for mobile services subscribed to in accordance
     with the terms and conditions of my contract with my current operator;
  4. I understand that all services of my current operator shall be lost;
  5. I understand that I shall be solely liable for any contractual obligations not met with my current operator;

  Signature* / Sahihi* ........................................................................................................................

  Date* (DD/MM/YY) / Tarehe*(TAREHE/MWEZI/MWAKA) ...............................................................

  *Required / *Yanayohitajika


  FOR OFFICIAL USE / KWA MATUMIZI RASMI

Verification of Subscriber Identification / Kuthibitisha utambulisho wa Mteja
ID Inspected / Uchunguzi wa kitambulisho
Type / Aina ................................................................ ID No / Nambari ya Kitambulisho. ...................................................................
Operators reference Number / Nambari marejeo ya mtoa huduma ....................................................................................................
New SIM Card Number (IMSI) / Nambari mpya ya SIM Kadi (IMSI) ....................................................................................................
Date / Tarehe ...........................................................................................
Time / Saa ................................................................................................

Order taken By: / Agizo limechukuliwa na:
I confirm that I have checked and retained copies of the Customer ID and authorization letter, where applicable:
Nathibitisha ya kuwa nimechunguza na kuchukua nakala ya utambulisho ya Mteja pamoja na barua ya idhini, pale inapohitajika:

Name / Jina ....................................................................................................................................................................
Signature / Sahihi ...........................................................................................................................................................
Date / Sahihi ...................................................................................................................................................................

								
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