India Demand Draft Form

Members ID Number: Members Name: Date of Application: Service Starter Executive Elite Price INR 5,625 INR 11,250 INR 33,750 Service Tax (10.3%)* INR 579 INR 1,159 INR 3,476 Total INR 6,204 INR 12,409 INR 37,226

*Mandatory Indian Government Service Tax. Please submit the Demand Draft Form and Demand Draft to the office in Mumbai no later than Saturday following the date of your initial application in order to preserve your assigned genealogy position and Talk Fusion Global ID number. Your Video Communication Center will become active within 2 -3 business days of receipt of payment.

Demand Draft Information: Please make in favor of: Talk Fusion India Private Limited - Mumbai
(Please note: Demand Drafts issued by a cooperative bank are not accepted)

Demand Draft#: Bank Name: Bank Branch Drawn On:

Please mail or deliver this form and the Demand Draft to the following address: Talk Fusion India Private Limited Solitaire Corporate Park Tower #6, Suite 602 Village Chakala, Andheri Kurla Road Andheri (EAST), Mumbai 400 093, India