(FOR CHANGE OF NAME)

EXECUTED ON RS.100/- NON-JUDICIAL STAMP PAPER

It is solemnly declared that I have purchased Plot No. ______________________

________________________________________________________________________
Mohallah _______________________________________________________________
Which has been transferred in my name in the revenue record.
I further confirm that Mr. /Mrs. /Ms. ______________________in whose name
gas connection provided at Plot No. ______________________________ has vacated the
premises and the same is under my occupancy as a landlord.
I assure that I will abide by the rules and regulations set by M/s Sui Northern Gas
Pipelines Limited.
I also undertake that I will be responsible of all payments concerning gas
connection at the above premises. I declare, in all sincerity that the papers/particulars
provided by me for transfer of gas connection in my name are true to the best of my
knowledge, and in case any thing is found contrary to the facts, The Company will have
the right to initiate disconnection of gas supply without any prior notice.
Signatures:

__________________________
(Purchaser)

Name:

__________________________

S/O, W/O, D/O: _________________________

Address:

__________________________

NIC No.

__________________________

NOTE: The following documents are required

1.
2.
3.
4.
5.

An affidavit execution Rs.100/- (matter as above).

A copy of sale deed (attested by Oath Commissioner).
A copy of last paid gas bill.
A copy of National Identity Card (Purchaser).
An application (in the name of Chief Sales Officer).