Application Form For New Connection
Division
*
:
Select
South Division(D00PQ)
dd(DD)
North Division(D001)
New Division(D002)
Consumer Name
*
:-
First Name
:
Middle Name
:
Last Name
:
Father / Husband's Name
*
:-
Relation
S/O
D/O
W/O
First Name
:
Middle Name
:
Last Name
:
Occupation
*
:
Consumer Address :-
For Communication :
House No
:
Street
:
Select State
*
:
Select
Delhi & NCR(DN01)
Uttar Pradesh (E)(UP01)
Uttar Pradesh (W)(UP02)
Maharastra(S001)
s1(CON0000123)
Select City
*
:
Select
Locality
:
PIN Code
:
Where Connection is Required :
House No
:
Street
:
Select State
*
:
Select
Delhi & NCR(DN01)
Uttar Pradesh (E)(UP01)
Uttar Pradesh (W)(UP02)
Maharastra(S001)
s1(CON0000123)
Select City
*
:
Select
Locality
:
PIN Code
:
Landmark
:
Nearest Pole
:
Permanent Address :
House No
:
Street
:
Select State
*
:
Select
Delhi & NCR(DN01)
Uttar Pradesh (E)(UP01)
Uttar Pradesh (W)(UP02)
Maharastra(S001)
s1(CON0000123)
Select City
*
:
Select
Locality
:
PIN Code
:
Type Of Connection
*
:-
Connection Type
:
Select
Domestic
Industrial
Non Commercial
H.T I
H.T II
H.T III
Cottage Industries
Agrl. Purpose
N.D and Commercial
Public Lighting
General Purpose
Temporary Supply
cooon1
con00001
con00000123
domestic1
c1
conn 1
c2
con1
Required Load
*
:
KW/HP/KVA.
Calculate Load
Consumer Type
*
:
Select
Individual
Private Limited Company
Registered Partnership
Un-Regd. Partnership
Any Other Legal Personal
New
con00001
con00000123
c1
ind
con000123
con000124
Processing Fees
:
PhoneNo/MobileNo
:
Email ID
:
Plot Size(sq. meters)
*
:
Covered Area(sq. meters)
*
:
Proof of Address
*
:
Select
PAN
ICard
DL
IdProofNo
*
:
Prosessing Fee Details :-
Amount
*
:
Mode Of Payment
*
:
Select
Cash
Cheque
Draft
Cheque / DD No.
:
Date
:
Bank Name
:
Following information is to be furnished by Applicants Requesting Electric Supply more than 50 KW and for Industrial Purposes. :-
(a)
Type Of Unit
*
:
Select
Individual
Private Limited Company
Registered Partnership
Un-Regd. Partnership
Any Other Legal Personal
New
con00001
con00000123
c1
ind
con000123
con000124
(b)
Name Of Institution Developing Industrial Premises
*
:
(c)
Possession letter or NOC Issued by the institution ( copy enclosed)
*
:
Upload Document
No
:
Date :
(d)
Whether supply is needed through Independent feeders
*
:
Yes
No
(e)
Whether the unit ever operated at some other place or applied for connection ?
*
:
Yes
No
(If yes, Please furnish the Following)
Sanction Load
*
:
Connection Number
:
Arrears (if any)
:
Address
:
(f)
Is electricity connection for the premises is being requested in the past ?
*
:
Yes
No
(If yes, Please furnish the Following)
Name of Unit
*
:
Connection Number
:
Arrears (if any)
:
(g)
Purpose of process for which Electricity Load is required
*
:
(h)
Nature Of process
*
:
(i)
Registration No. from Deptt. of Industries (Copy to be enclosed)
*
:
Upload Document
No
:
Date :
(j)
NOC from Pollution Control Board(Copy to be enclosed)
*
:
Upload Document
No
:
Date :
(k)
Name of the Agency Financing the unit(Bank/Self/any other)
*
:
(l)
Proposed date of start of Production
:
(m)
Is there any other unit operating in the vicinity
:
Yes
No
(If yes, Please furnish the Following)
Name of Unit
:
Address
:
(n)
Please specify voltage ratio & capacity of the nearest Electricity sub station and its distance from the unit
Voltage Ratio:
Capacity:
Distance:
Neighbour Connection Number
*
:
1. Do you already have any connection.If yes, then give the Connection Number.
Yes
No
Consumer Number
:
2. Is the premises for which connection is requested, is on rent.If yes, then upload the scanned copy of NOC from the owner or Imdemnity bond.
*
Yes
No
Upload NOC by Owner
:
Upload Imdemnity bond
:
Note :
In case of Imdemnity Bond You must have to submit the Original copy Either by post or personally.
*
3. Is your request is rejected previously. If yes, then give the reason.
Yes
No
Enter Reason
:
4 (a).Is there any premises or plot between the poll and the premises for which connection is requested.
*
Yes
No
4 (b).If yes, then the new poll is planned at the cost of consumer.
*
Yes
No
5. Are you a BPL card owner (copy to be enclosed).If yes then provide detail.
*
:
Upload Document
Yes
No
No
:
Date :
Enclosures:-
1 :
In case of consumers without MDI meter the connected load can be 200% of the contracted load in the domestic category and 133% of the contracted load in the commercial category.
2 :
In your own interest, please ensure permanent disconnection of your electric supply, and obtain "No Dues Certificate" from division before vacating the premises.
3 :
Electric Connection shall not be treated as a proof of ownership of the premises.
4 :
In case of consumers without MDI meter the connected load can be 200% of the contracted load in the domestic category and 133% of the contracted load in the commercial category.
5 :
In your own interest, please ensure permanent disconnection of your electric supply, and obtain "No Dues Certificate" from division before vacating the premises.
Note 1 :
In case of consumers without MDI meter the connected load can be 200% of the contracted load in the domestic category and 133% of the contracted load in the commercial category.
Note 2 :
In your own interest, please ensure permanent disconnection of your electric supply, and obtain "No Dues Certificate" from division before vacating the premises.
Note 3 :
Electric Connection shall not be treated as a proof of ownership of the premises.
Declaration
*
:-
I/we solemnly assure and undertake that A. I/we hereby declare that I/We desire to have and agree with the Licensee to take a supply of energy for the above mentioned purposes, for a period of not less than 2 years from the date of commencement of supply and to pay for the energy so supplied and all other charges at the rates set out in the Tariff order. B. I/We also agree to be bound by the Licensee's Distribution Code as approved by the Commission including any modification thereof and the provisions of Electricity Act, 2003 together with the rules framed there under. C. I/We also declare that in the event of my/our failure to comply with the above provisions, it shall be lawful for the Licensee to discontinue the supply in terms of the aforesaid Distribution Code. D. I/We further declare that the Licensee shall not be held responsible for any interruption / diminution of supply for reasons beyond its control. E. I/We understand that this declaration can be canceled after two years by either party giving notice as per the procedure described in this code. F. I/We further agree that this declaration given by me / us shall be construed as an Agreement with the Licensee to the above effect. G. I/We declare that all details furnished in the Application form are true to my / our knowledge.If any information is found incorrect at the later date, then the Licensee shall have the right to withhold / disconnect supply , as the case may be. H. It shall be ensured by me / us that there is no unauthorized addition / alteration to the equipment or unauthorized use of electricity. In other words, it shall be ensured by me / us that the energy provided to me / us by the Licensee is utilized as per law and authorization. In case the Licensee has reasonable basis to understand or apprehend that there is in any way whatsoever unauthorized addition / alteration to the equipment or unauthorized use of electricity, it shall be open to the designated authority of the Licensee to enter upon the premises for general inspection and testing of the equipment, meter and wiring etc. I. I / We undertake to intimate the Licensee as per the procedure described in the Electricity Supply Code - 2005 whenever I intend to vacant the premises for which the electric connection is being taken.
I accept the above terms and conditions.