This form requests an update to a consumer's landline and mobile contact information. It asks for the consumer number, name, mobile number which can be used for automated refill booking and alerts, and landline number which can be used for refill booking. The consumer must sign the form before submitting it to their distributor.

1. Update Landline / Mobile
*Note: Please submit filled form to your distributor
Consumer Number :
Consumer Name :
(Title) (Last Name) (First Name) (Middle Name)
Mobile Number :
It can be used for IVRS Refill Booking / SMS Refill Booking / Mobile application / Receive Bharatgas alerts
Landline Number : (STD) -
It can be used for IVRS Refill Booking
Signature