Professional Documents
Culture Documents
Form No.2
Form No.2
2
(See Regulations 3)
APPLICATION FORM
NEW CONNECTION/ LOAD ENHANCEMENT/ LOAD REDUCTION/ CHANGE OF NAME
(FOR OTHER THAN DOMESTIC AND GENERAL PURPOSE CATEGORY)
(Through SDO
…………………………………………………………………..)
Dear Sir,
I / We hereby request you for New connection/Alteration in Existing Connection/ Temporary Connection
to supply electrical energy at High Voltage/ Extra High Voltage for the premises owned / occupied by
me/ us.
Sl. No Particulars
1 Application For:
New connection Change of
Name/Transfer of
service connection
Load Enhancement Load Reduction
2 Name of the Applicant/
Organization:
(In Capital Letters)
3 Name of father/ husband/
Director/Partner/Trustee:
(In Capital Letters)
4 Consumer No.
(If application is not for New Connection)
5 Purpose of power supply (Tick mark only one of the appropriate option) :
Private residence Cinema
Factory Workshop
Industry, Restaurant
Irrigation, Mill
Pump Allied agricultural
activities
83
Domestic (Bulk) Allied Agro Industrial
Activities
84
18 Address Details of the premises for which new service connection is applied for / existing
connection is required to be shifted
Name of Applicant (In Capital Letters):
First Name:
Middle Name (If any):
Surname:
22 Whether the requisite consent/ NOC (if applicable as per the list of Pollution Control Board) has
been obtained from …………… as per statutory requirements (If yes, attach a copy)
23 Any electricity dues outstanding in licensee’s area of operation in consumer’s name: Yes/ No
24 Any electricity dues outstanding for the premises for which connection applied for :Yes/ No
25 Any electricity dues outstanding with the licensee against any firm with which the consumer is
associated as an Owner, partner, Director or Managing Director: Yes/ No
(For questions 23,24 and 25
if the answer is ‘Yes’ in any
case, please provide details
on a separate sheet)
1. Light
2. Fans
3. Plug Points
4. Plug points
Appliances i.e., iron,
Cooker, Refrigerator.
5. Consignees.
_________________________________________________________________
Total:
85
(b) MOTORS AND OTHER APPLIANCES.
Total:
86