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) Authorized Signatory of LRA (Director/Owner) Signature & company seal Sify Channel Manager Recommendation ( Recommendation for appointment with justification ) Date of Visit & location : I have understood all the terms and conditions of process and compliance of Sify Technologies Ltd (Safescrypt CA) and will abide to them. Name: Signature & Company seal: (LRAA s Authorized Signatory) Date: / /2012 Passport size photo Note : Kindly attach company profile with this sheet. Sify LRAA Ap.

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