Application Form
Fixed Number Porting
Home Services
First Name*: ...................................................................................................................................................................................... Last Name*: ......................................................................................................................................................
Date of Birth (DD/MM/YYYY): ................................................................................................................................. Nationality: ......................................................................................................................................................
ID Type : Passport or Emirates ID or GCC ID Mobile Contact No.: ............................................................................................................................
ID Number* : .....................................................................................................................................................................
Account authorised signatory details*
. Business (Home Services/Business)
First Name*: ..................................................................................................................................................
Company Name*: .......................................................................................................................................................
Last Name*: ..................................................................................................................................................
Company Address Details: ...........................................................................................................................
Mobile Contact No.: .........................................................................................................................
* Trade License or * Establishment Card
ID Type: Passport or Emirates ID
ID Number* : .....................................................................................................................................................................
ID Number*: .................................................................................................................................................
*Company ID document, Authorised signatory
ID document and Power of Attorney must be attached
I hereby request to port the following number(s)
From the Donor Operator EITC to Recipient Operator Etisalat
In case the Fixed line is part
of a Bundled service, then
Port In Port Back entire Bundle along with all its
constituent services and any
Fixed Line Number: additional services attached
to it whether its voice or non
voice will be ceased
OR
I hereby request to port the following range of numbers (applicable only for business services)
First number in range Last number in range
All additional numbers are in attached Schedule 1.
*Mandatory Fields
8372/Porting/April 2021
Terms & Conditions
Fixed Number Porting
Subject to the successful validation of the porting request If you are an individual:
by the Donor Operator, the Recipient Operator will use its
reasonable endeavors to port the requested number(s) as soon I hereby confirm and certify the full authority and capacity
as possible within the defined SLA (between Donor, Recipient, to request for porting the number(s) stated and listed in this
and TRA) from the time, when the Recipient Operator sends the application form and information provided herein are true and
porting request to the Donor Operator. correct.
I agree to cease the entire bundle along with all its constituent OR
services and any additional services attached to it whether its
voice or non voice provided from the Donor Operator under the If you are a Company:
ported number(s) and undertake to pay and settle in full all
such outstanding charges and debts due to the Donor Operator
I,________________________________________________
promptly, and in accordance with the Terms and Conditions in
my contract with the Donor Operator.
(Name of Authorized Signatory) the authorized representative
on behalf of the Company confirm and certify the full authority
I authorize the Recipient Operator to request cancellation of all
and capacity to request for porting the number(s) stated and
the Services provided under the ported number from the Donor
listed in this application form and information provided herein
Operator on my behalf.
are true and correct via the Power of Attorney (as attached) and
accept all the terms and conditions stipulated in this porting
In such circumstances, where the Donor Operator suspends/ request form.
ceases the constituent services being provided under the ported
number, I will not hold the Donor Operator liable for such
I, by signing this application form, acknowledge that I have read
suspension/cessation or any resulting effects of such action by
and agree all the Terms and Conditions (T&Cs) contained in this
the Donor Operator.
application form:
I am the authorized person to request the porting of the
number(s) listed in this form and agree to initiate the porting of
the mentioned number(s);
Customer signature* (with mandatory stamp for business services)
Date : _____________________________
