Roaming & Auto Billspay Serial #

Subscription Form

This part to be filled by subscriber (in English block letters)

GP Mobile Number 0 1 7
Name of the Subscriber/Company

User Name

Contact Information
Subscriber's Contact Number Office/Home/Cell

E-mail Fax:

Tick (ü) Auto Debit for Local Auto Debit for International Roaming Standard Roaming SMS Roaming
your choices Tick (ü) any one
Both IR without Auto Billspay Basic Roaming Data Roaming

Collection Criteria (Please Select)

Local International Roaming
Charge as the usage exceed amount BDT: 1000 Charge as the usage exceed amount BDT: 500

Charge as usage exceed % of Credit Limit** Charge as usage exceed % of Credit Limit**

Charge after billing date Charge after billing date

* Any outstanding amount at the end of the billing period will be collected after bill date
** Customer can choose between 10-100% & may experience barring if total usage crosses credit limit

Card Holder’s Information

Bank Name Visa Master Amex Others

Card Number

Expiry Date M M Y Y Credit Card Debit Card

Card Holder's Name

(As appearing in the card)

Organizational Authorization Bulk IR Registration

I hereby authorize the aforesaid mobile subscription owned by our The Standard/Basic/SMS/Data Roaming have been activated in …………………….......................... (Number of
organization to its user who is our employee for the purpose of availing SIM) as per attached Bulk IR Subscription Form (Form serial No. ................…………)
International Roaming. With this I declare that all the bills/ against……………………………………..............................………..(Name of the company/organization). I on behalf of
advances/securities will be settled from the International Credit Card of company/organization take responsibility of these SIMs for International Roaming service and
the user. hereby accept the terms and conditions written in International Roaming subscription form.

Company Seal Signature of the Company Authorized Person Company Seal Signature of the Company Authorized Person

I hereby give full and unconditional authority to GP to debit my int’l/local Credit/Debit Card/account through the Authorized Bank for GP mobile phone IR/local payable as & when it shall accrue. I am also authorizing GP to
ask for settlement to my bank for IR/local payables. I understand that GP may charge the amount any time after being payable and that GP shall not be liable for any late collection of the amount due to any reason
whatsoever. I also understand that my card information along with copy of standing instruction will be reserved by GP & the Authorized Bank. I hereby also agree that I shall not dispute regarding aforementioned AUTO DEBIT
payment to GP debited from my card or account under this ‘Standing Order”. If any excess of or less than the actual IR or Local Bill is debited, the correction will be made with the next bill(s) (if any). I also understand that, my
connection will have to comply with GP’s existing credit policy & any violation of that policy might result in temporary/permanent barring of connection(s). I also hereby declare that for the purpose of availing the service of
International Roaming, I have no objection whatsoever using my personal International Credit Card with aforesaid number for the payment of the bills incurred and also understand that any kind of refund/adjustment from
Grameenphone will be settled within account of the mobile number stated above. I also agree to abide by Bangladesh Bank’s rules & directives regarding International Roaming.
I authorize Grameenphone to debit my Int’l Credit Card/Debit Card Expiry Date M M Y Y

for amount of Taka for Security deposit of International Roaming.

Date: / /
Signature of the User

Serial # Acknowledgement

GP Mobile Number 0 1 7

Auto Debit for Local Auto Debit for International Roaming Both IR without Auto Billspay

Roaming Type Basic Standard Data SMS Approval Code

Signature of the Company Authorized Person Date: / /
 IR TERMS & CONDITIONS 5. Bank & GP shall accept payment through this standing instruction form in the name of Auto Bills Pay form only
1. All charges or bills will be collected from the subscriber in foreign currency against his/her from mentioned bank Accounts or Credit/Debit Cards (Details as mentioned in the form). In case of Credit Card,
International Credit Card/Foreign currency accounts (If applicable), which is accepted by GP. All bills only the Primary Cardholder’s Card is acceptable for this kind of payment. Instructions in Auto Debit/Standing
have to be settled in Bangladesh on a monthly basis. Instruction form for auto bill payment will be executed subject to verification of signature by the bank as well as
subscribers details confirmed by GP and availability of credit limit of the Credit Card or sufficient balance in
2. Bangladesh national shall be required to deposit in foreign currency equivalent to Tk. 10,000 (With
Account/Debit Card. For business customers, the authorized signatory can subscribe using the company
auto debit) or Tk. 20,000 (Without auto debit) as security deposit against his/her International Credit
approved seal & signature (As applicable in banking transaction).
Card /Foreign currency account (If applicable) to avail GP Standard/Basic/Data Roaming service.
6. If, in the sole opinion of the Bank, the Account or the Card has insufficient funds or credit limit (As the case may
3. Foreign national residing in Bangladesh shall be required to deposit in foreign currency equivalent to
be), neither the Bank nor GP is responsible to the Accountholder/Cardholder for discontinuation of service.
Tk. 10,000 (With auto debit) or Tk. 50,000 (Without auto debit) as security deposit against his/her
However, in case of Card, at the sole discretion of the Bank, the transaction may be temporarily accommodated
International Credit Card/Foreign currency account (If applicable) to avail GP Standard/Basic/Data
along with traditional charges/penalties that are accrued in this regard & subscriber shall pay the bank
Roaming service.
according to the terms & condition of the card agreement between bank & the subscriber. GP shall inform the
4. The usage limit/credit limit for SMS roaming will be BDT. 1000 for subscribers who have 0 (Zero)
subscriber in case of non-payment mentioning the reason as confirmed by the concerned bank.
security deposit for SMS roaming. The subscriber can pay extra security deposit through his/her
7. Auto Debit/Standing Instruction form shall be in effect from the date when GP receives instruction from the
International Debit/Credit Card (If applicable) for SMS roaming usage. BDT. 1000 amount (Credit limit
subscriber and collection of bill will be in effect immediately after the bank has received this form from GP
over security deposit) is applicable for both local and International Roaming usage.
(Subject to bank verification) to proceed. The bill shall be, debited as & when required for any amount after the
5. Grameenphone has the right to terminate or suspend the provision of the services to the subscriber if
said effective date and shall be collected by GP through the concerned bank’s account or Credit/Debit card as
the total charges (Billed and to be billed) accumulated at any time exceed the subscriber's security
mentioned in this form & agreed by the subscriber.
deposit. However, the subscriber has the option to increase his/her security deposit, by one or more
8. The Chargeable amount shall be debited by bank from the Account/Card on the same working day after
slabs of Foreign Currency equivalent to BDT. 5,000 through his/her International Credit Card/Foreign
receiving the billing information from GP, irrespective of the last bill payment date mentioned on the bill. If the
currency accounts (If applicable).
payment instruction date falls on Friday or a public holiday or bank holiday, the same will be effective on the
6. The subscriber shall have to pay Government taxes, levies, VAT, surcharges and other charges (If any)
next working day/ or in the same day subject to respective bank’s arrangement.
applicable according to the Bangladesh Government's rules and regulations.
9. GP may generate an Interim Bill at any time during the billing cycle or month and submit it to the Bank for
7. The subscriber/user shall abide by the Bangladesh Bank's Foreign Exchange Regulations.
payment. The objectives of generating an Interim Bill are to ; (A) ensure the subscriber’s outstanding dues to
8. If for any technical reason or any other problem occurring at the home network, visited network GP (The Billing Company) does not cross his/her Mobile Phone’s credit limit at any point in time, and (B)
and/or in the international circuit, it is not possible to render IR services, GP shall not be liable for any prevent any disruption in the service of GP.
such issue. GP would strive to render best possible services.
10. The bank & GP shall not be liable for discontinuation of the service in the event of breakdown of machinery or
9. Grameenphone reserves the right to refuse providing or continuing service, terminate service. computer system, strike, lockout, war, terrorism, seize, act of God or any other reason beyond control of the
Nevertheless, Grameenphone reserves the right to change the terms and conditions, all tariffs Bank & GP.
applicable to Grameenphone outgoing roaming facility without assigning any reason whatsoever.
11. GP may generate an interim bill at any time during bill cycle and auto debit condition on specific date shall not
10. The subscribers shall visit the website of Grameenphone Ltd. to get informed about the charges and work in case of usage exceeded 90% of the credit limit.
details of the tariff applicable to them. The International Roaming payment procedure, as
12. Any queries, questions, comments etc. with regards to the service of GP and the billing amount shall have to be
implemented, are as per Bangladesh Bank’s Foreign Exchange regulation and service offered by the
taken up with GP through its appropriate existing process and payments to the Bank with regard to the
concerned International Credit Card/Foreign Currency accounts (If applicable) issuing
settlement of amounts paid in this regard are committed and not deferrable for any reason whatsoever. The
bank(s)/authority(s). The payment procedure, as determined, stipulated in the website and/or
transaction appearing on the Account Statement or the Card Statement shall be the proof of payment of the
communicated to the subscribers by GP, shall be binding upon them.
bill.
11. Grameenphone has the right to check the subscriber’s International Credit Card’s status,
13. Any complaint from subscriber regarding the auto debit instruction shall be raised to GP only and shall be
International Credit Card balance and block any balance from the card for security reasons.
resolved by the Bank and GP together. If any mismatch is detected between the debited amount and usage
12. The International Roaming subscriber shall be responsible for selecting the appropriate handset for amount of the subscriber, any type of refund/complaint on account of Auto Debit Instruction shall be settled
using international roaming facility in the visiting networks. Subscribers can have additional by GP to its subscriber through concerned bank.
information on this from Grameenphone Customer Management Division (CMD).
14. Auto Debit Instruction under this form shall remain in full force and effect till 60 (sixty) days of any cancellation
13. If a subscription is lost or stolen, Grameenphone will not be responsible for the lost or stolen phone of this instruction by Accountholder/Cardholder/subscriber receipt by the bank from GP and any such
or any subsequent fraudulent use of the mobile phone/SIM card. In case of lost SIM, the subscriber amendments/cancellations of the form shall not release the accountholder/Cardholder/subscriber from the
must immediately fax a written request to GP entailing account ID, mobile number and signature as liability to the Bank & GP arising on account of his availed service from GP before such
on the subscription form to suspend/bar his/her subscription. amendments/cancellations.
14. GP International Roaming Application form will be considered as a supplementary document of 15. The Terms & Conditions of this form shall be governed by the laws of Bangladesh as applicable from time to
Grameenphone's application form. All terms and conditions of both shall therefore be applicable to time.
the user of GP "International Roaming Services."
16. The Bank & GP may revise and/or change any of the terms & conditions at any time without any prior
15. IR subscriber(s) are requested to preserve this form, if it is lost in any way, the subscriber must lodge notification. However, such changes shall be effective from the date specified by GP & shall be notified to the
a GD (General Diary) with the concerned Police Station and communicate the same to GP for future Accountholder/Cardholder either in writing or by publication or SMS to the subscriber by GP.
reference and availing customer service.
17. Notwithstanding anything contained herein above, for Credit Card, this Auto Billspay instruction will remain
16. Responsibilities of GP are explicitly stated in this agreement as above and GP takes no other valid till the expiry date of the Credit Card and will be deemed as renewed upon the renewal of the Credit Card
responsibilities besides those. (valid for GP authorized bank only) subject to any cancellation notice served by the subscriber or any
17. IR bill is charged based on the charging record that roaming partners claim/send. It could take up to declaration by the Authorized Bank of such cancellation.
three months from your overseas return for the last roaming charges to appear on your 18. Subscriber hereby acknowledges that, the mobile subscription with details provided above belongs to
Grameenphone bill. subscriber/his Company and shall be used by the subscriber/the employees of the respective company.
18. IR bill may cross the customer’s given limit and may not be barred as we receive the billing records However, if the auto debit subscriber leaves the organization (in case of Business customer), then it is the
from roaming partners for customers in bulk and in delayed time. responsibility of both the Company as well as the user to let GP know about the status of the incidence by an
19. If you are a Smartphone user, in that case various software or application on your Smartphone may official letter. In that case, if the Company wishes to settle its bills by a different Cardholder, then the new
initiate data sessions automatically. For example, it may check for new updates or email on a user’s details (Copy of card & Auto Debit/Standing Instruction form) through a similar procedure shall be sent
frequent basis. This may incur higher data usage and additional high roaming cost without your to GP.
notice. To avoid any such unpleasant situation, you may disable data service when not in use. 19. Subscriber hereby declares that she/he has no objection what so ever regarding settling his/her
AUTO DEBIT TERMS & CONDITIONS Personal/Company’s mobile Bills and Security Deposits (if any) from his/her account or card, which is detailed
1. GP shall share a copy of this form with the bank and bank shall charge the bill upon GP’s request above.
untill any cancellation request is received and accepted by GP from the Subscriber. Subscriber shall 20. Subscriber understands that GP is the beneficiary to the payment process and shall only settle the amount
not give any instruction to the Bank that amounts to restriction upon the Bank for payment of bill to stated on Bills payable on his/her Personal/company’s account of the ID and Mobile Number(s) stated above.
GP for availing the service from GP. Bank shall disregard such instruction unless it is accepted by GP. 21. In addition, the subscriber hereby agrees that in the event of insufficient limit in the subscriber’s account or
2. Authorized Bank: Account holding bank of the subscriber or any other bank with whom GP has Credit Card to cover the respective amount, the International Roaming/Local bill Auto Debit payment
collection arrangement to carry the transaction of debiting the account/Credit/Debit card of the transaction shall declined and notification shall be given to him/her by GP & service will remain barred till the
subscribers. payment request is honored by the bank.
3. This auto debit instruction authorizes GP/concerned Bank (schedule banks)/financial institutions of 22. Subscriber also understands that, subscriber’s Personal/Company’s mobile shall have to comply with GP’s
Bangladesh to update subscriber’s database for credit or Debit Card /Bank A/C information even in existing Credit policy and any violation of that policy might result in temporary/permanent barring of mobile
the case of renewal/expiry/cancellation of the Bank Account or Credit/Debit Card with the same connection(s) and any type of refund regarding International Roaming/Local bill shall be settled with the
bank for GP mobile bill settlement. In case of cards (i.e. credit or debit) issued outside of account holder or the Credit Card holder only.
Bangladesh, customer is solely responsible to inform new card information to GP for uninterrupted 23. GP & the Bank reserves the right to accept or deny this standing instruction in the name of Auto BillsPay and
service. With regard to Card (i.e. Credit or Debit) expiry date, subscriber will receive a notification any instruction thereof at their discretion however in case of denial the bank or GP shall notify the subscriber
from GP. about the reason behind the such denial.
4. If the information relating to expiry or cancellation or renewal of any Account and/or Credit Card is 24. GP & the Bank shall have the right to check the Subscriber’s financial information in relation to the provided
not received by GP either from Bank or from subscriber on or before of such cancellation or renewal Account or Card and block any balance from the Account or Card for security reasons
or expiry, the International Roaming/Local auto debit service will be discontinued till new 25. GP will notify subscriber though SMS for charging, decline, regarding expiry date & automatic update of credit
information received from the customer with properly filled Auto bills pay form. or debit card from bank.

Date/ ZvwiL Card Holder’s or Account Holder’s Signature KvW© †nvìvi A_ev A¨vKvD›U †nvìvi-Gi ¯^v¶i Stamp/seal (if company) ÷¨v¤ú/wmj (†Kv¤úvwbi †¶‡Î)
Auto Debit Form/April'17