West Bengal State Electricity Distribution Company Limited
———————————————————————————————————————
Annexure – A1
Application form to be used for transfer of service/meter in case of change of ownership or occupancy of any premises or change in purpose of supply
*(Please strike out inapplicable items)
(TO BE SUBMITTED IN DUPLICATE)
[See regulation 7.1]
To:
___________________________
(Name of Licensee)
___________________________
(Address of Licensee)
___________________________
___________________________
Sir,
1.I / We hereby apply for transfer of service/meter/change in purpose of supply in my / our favour at the premises having the following address:
_________________________________________
_________________________________________
_________________________________________
_________________________________________
2.This is an application for existing service with the connected load as follows for domestic / commercial / industrial / …………………..(other purpose to be mentioned) purpose.
(A)FOR CHANGE OF OWNERSHIP OF EXISTING SERVICE:
(i)Consumer No.
(ii)Name of the existing consumer:
(iii)Name of new owner/occupier:
(iv)Present category of load (viz. Domestic / Commercial / Industrial etc.)
(v)Present sanctioned Load –
(a)Connected Load KW / HP ____
(b)Contract Demand (For HT & EHT) KVA _______
(c)Present Voltage ____
(vi)Proposed reduction in Load in KW / HP _______
(B)FOR CHANGE OF PURPOSE OF SUPPLY:
(i)Consumer No.
(ii)Name of the consumer.
(iii)Present category of load (viz. Domestic / Commercial / Industrial etc.)
(iv)Proposed category of load (viz. Domestic / Commercial / Industrial etc.)
(v)Present sanctioned Load –
(a)Connected Load KW / HP ____
(b)Contract Demand (For HT & EHT) KVA _______
(c)Present Voltage _________
3.I / We hereby declare that I / we shall abide by all provisions of the Electricity Act, 2003 and the Rules / Regulations / Orders / Statutory Notifications made under the Electricity Act, 2003, as amended from time to time.
4.I / We have confirmed to furnish security deposit newly determined by you in terms of the regulations made under section 47 of the Electricity Act, 2003 along with the first electricity bill on effecting the service against this application.
5.I / We undertake to replenish any shortfall in security deposit if and when required and for the value of meter(s) and other apparatus installed / to be installed at my / our premises.
6.I / We also enclose copies of documents showing in principle clearance for establishment wherever applicable from the Pollution Control Board concerned.
7.I / We also enclose copy / copies of
(i)……………………….) any other documents of which compliances
(ii)………………………) are called for
(iii)…………………….. )
8.Please provide me / us with the service as requested.
|
|
Yours faithfully, |
Enclosed: As stated. |
____________________________ |
|
(Signature of the applicant(s) with date) |
|
Full Name ___________________________ |
|
(In Block letters) |
|
Full Address: _________________________ |
|
(In Block |
|
|
letters) |
_________________________ |
_________________________
Telephone No(s),______________________
if any.
Witness (1)
Signature with date _____________________________
Full Name |
_____________________________ |
Address |
_____________________________ |
Witness (2)
Signature with date _____________________________
Full Name |
_____________________________ |
Address |
_____________________________ |
———————————————————————————————————————
For use of the licensee / supplier
(To be filled up by the licensee/supplier on receipt of the application-cum-agreement form submitted by the intending consumer and the duplicate is to be handed over to the latter)
Accepted for and on
Behalf of the licensee/supplier
(Signature with date of the accepting official under the stamp/office seal of the licensee/supplier)
Address:
_____________________________
_____________________________
_____________________________
_____________________________
Annexure – A2
Format of no-objection certificate to be issued by the consumer of the existing service in favour of another person applying for transfer of name of service. [See regulation 7.2(a)]
To:
___________________________
(Name of Licensee)
___________________________
(Address of Licensee)
___________________________
Sir,
I, Shri/Smt ………………………………………………………, the consumer (Consumer
No. ………………………………) hereby request you to transfer the service in favour of
Shri/Smt.…………………………………………. along with security deposit.
OR
I, Shri/Smt …………………………………………………………, the consumer (Consumer
No. ………………………………) hereby request you to transfer the service in favour of
Shri/Smt.…………………………………………., but my security deposit may be refunded to me.
Yours faithfully,
(Signature of the original consumer with date)
Full Name ______________________________
(In Block letters)
Full Address: _______________________________
(In Block letters)
________________________________
________________________________
Telephone No.(s), if any_______________________
Consumer No. ------------------------------------------------
-
Annexure – A3
Format of No-objection certificate to be issued by other legal heir(s) of a consumer, who has died, in favour of one legal heir who is applying for transfer of the service owned by the deceased consumer.
[See regulation 7.2(b)].
A F F I D A V I T
IShri/Smt …………………………………………………………, son / daughter / wife of ______________________________________, aged about _____ years, by faith ____________, by occupation ____________, residing at ____________________
___________________________________________________________________, do hereby solemnly affirm and say as follows:
That I, the legal heir of Late Sri / Smt………………..………………………….…, the
consumer (Consumer No. ………………………………), have no objection to
transfer the service (Consumer No.…………………………………) in favour of
……………………………………..…………
That the statements made above are true to my knowledge and belief.
Prepared in my office, |
The deponent is known to me. |
Advocate |
Clerk to Sri __________________ |
|
Advocate |
Solemnly affirmed before me, on |
|
This the _______ day of ______________ |
|
Annexure – B
Application form to be used by an intending consumer/ a consumer requesting the licensee for new connection / extension of load/ alteration of service.
*(Please strike out inapplicable items)
(TO BE SUBMITTED IN DUPLICATE)
[See regulation 3.1.2 and 3.1.3]
To:
___________________________
(Name of Licensee)
___________________________
(Address of Licensee)
___________________________
___________________________
Sir,
1.I / We hereby apply for supply of electricity in my / our favour at the premises having the following address:
_________________________________________
_________________________________________
_________________________________________
_________________________________________
2. This is an application for new service / extension of load under existing service/
alteration of service and the expected connected load (in KW/HP) will be as follows for domestic / commercial / industrial / …………………..(other purpose to be mentioned)
purpose.
(A)FOR NEW CONNECTION:
(i)For LV & MV : Connected Load…………………….KW/H.P
(ii)For HV & EHV
Voltage of Supply Connected Load (KW/HP) |
Contract Demand (KVA) |
___________________ |
__________________ |
(B)FOR EXTENSION OF LOAD UNDER EXISTING SERVICE:
(i)Consumer No.
(ii)Present sanctioned Load –
(a)Connected Load KW / HP ____
(b)Contract Demand (For HT & EHT) KVA _______
(c)Present Voltage _________
(iii)Extended Load required (including present load) -
(a)Connected Load KW / HP ______
(b)Contract Demand (For HT & EHT) KVA _______
(c)Proposed Voltage _________
(C)FOR ALTERATION OF SERVICES:
(i)Consumer No.
(ii)Present category of load (viz. Domestic / Commercial / Industrial etc.)
(iii)Shifting – Rough sketch to be attached
(iv)Alteration – Nature of alteration (viz. Category, Phase, Shifting and Others)
3.I / We hereby declare that I / we shall abide by all provisions of the Electricity Act, 2003 and the Rules / Regulations / Orders / Statutory Notifications made under the Act, as amended from time to time.
.
4.I / We have already paid / I/we hereby tender an amount of Rs. ___________
(Rupees _____________________________________) only as the amount recoverable
from me / us under the regulations made under section 46 of the Electricity Act, 2003 and as per the cost estimate prepared by you and sent to me / us from your end vide your letter no. ______________________ dated ________________.
5.I / We agree that if there is any difference between the amounts, I / we have paid as per provisions of the regulations made under section 46 of the Electricity Act, 2003, and the amount that is finally determined to be recoverable from me / us, the difference will be adjusted with my / our electricity bills in not more than 4 (four) consecutive installments.
6.I / We have also tendered / I/we hereby tender an amount of Rs. ____________
(Rupees _____________________________) only as my / our security deposit determined by you in terms of the regulations made under section 47 of the Electricity Act, 2003 and as per estimate prepared by you and sent to me / us from your end vide your letter no. _________________ dated ________________.
7.I / We undertake to replenish any shortfall in security deposit if and when required and for the value of meter(s) and other apparatus installed / to be installed at my / our premises.
8.I / We enclose a Test Form for internal wiring signed by my / our licensed electrical contractor.
9.I / We also enclose a Way Leave permission in Form – 1 for erection and fixing of necessary apparatus on or within the premises.
10.I / We also enclose copies of documents showing in principle clearance for establishment from the West Bengal Pollution Control Board concerned.
11.I / We also enclose copy / copies of
(i)………………………. ) Any other documents
(ii)……………………… ) of which compliances
(iii)…………………….. ) are called for
12. Please provide me / us with the service as requested.
|
|
Yours faithfully, |
Enclosed: As stated. |
____________________________ |
|
(Signature of the applicant(s) with date) |
|
Full Name _____________________________ |
|
(In Block letters) |
|
Full Address ___________________________ |
|
(In Block |
|
|
letters) |
____________________________ |
|
|
____________________________ |
|
Telephone No(s), ________________________ |
|
if any. |
|
Witness (1) |
|
|
Signature with date |
_____________________________ |
Full Name |
_____________________________ |
Address |
_____________________________ |
Witness (2)
Signature with date _____________________________
Full Name |
_____________________________ |
Address |
_____________________________ |
———————————————————————————————————————
For use of the licensee / supplier
(To be filled up by the licensee/supplier on receipt of the application-cum-agreement form submitted by the intending consumer and the duplicate is to be handed over to the latter)
Accepted for and on
Behalf of the licensee/supplier
(Signature with date of the accepting official under the stamp/office seal of the licensee/supplier)
Address:
_____________________________
_____________________________
_____________________________
_____________________________
