69599324179697

ay ment Receipt #
Pplicalton Detail ASIS RANJAN MOHANTY

TPC10206434

Name

Unique Permancnt Application Phase)

No(UPAN) (Domestic
Single
Connection
New
9777580347
Application For

Registered Mobile No

PAN No

GST No

Traasaction De(ails
Online Payment

Payment 1ype YHD41425675972

Transaction ID Successful

Transaction Status 2022-09-21 16:45:48

Transaction Date

Pay n e n t Details

Amount
Item Namne 50.00
SI No.
Processing Fees(Excl.GsT @18%): 1500.00

Service Connection Charges(Excl.GST

2.
@18%) 30.00
Inspection Fees
3. 1282.00
Security Deposit :
. 1271.0
5. Meter Cost (Excl.GST @18%): 4641.00
of l8% i.c. R508.00) six hundred & forty o n e
Total (Including GST Charges
(Rupees four thousand Only)

Pees, GS7 & Inspection fee is not refundable)

(NB: In case
of rejection of application the P'rocessing
computer-generated
document. No signature is required.
This is a
 Form No.
(See Regulations 3)
New Service Connection /
Appliation Form # TPC10206434
Load enhancementhLoad reduction Reconnection Ghange of
SupplyConversion of Servicef Ghange of consumer category *ameSttngtemporary
(FOR DOMESTIC&GENERAL
To
PURPOSE OTHER THAN BULK DOMESTIC sUPLY CATEGORY)
The Junior
Engirieer Sub-Divisional Engineer.
Angul No llANGUL Sub Division
Sir,
1. IWe hereby request you for a new service connection to supply electrical energy to the premises owned ocCupied by me us and
hereinafter described. 1We am/are the owner/lawful occupier of the
premises at KHATA NO-432-607 PLOT NO-238-5618 ANGUL in
whicth supply ot elcctrical
energy is now required.
2.We agree to take
supply for Two YEARS to utilise the energy tor Residential purposes only for
my/our use. Thereafter Agreement
shall so continue unless
terminated by either of the parties after giving one monihs notice
we agree to pay tor the serviCe connectuan and other dues
including the securily as may be payable arnd shall al'so pay the
charges.
Surcharges. eleciricity Guty in accordance with the OERC DIstribution (Conditions of Supply) Code. 2019 provided that annual sum
payable individually by me/us under the proviso Section 45 of the Electricity Act. 2003 shall not be deemed to be part of the minimum
monthly charges or demand charges, if any. payable under the OERC Distribution (Conditions of Supply) Code. 2019.
. wWe have obtained and perused a copy of OERC Distribution
(Conditions of Supply) Code. 2019 and understood its contents and
hereby undertake to observe and comply with the terms and conditions stipulated theren to the extent they are applicable to me/us.
. IWe further
require you to
supply merus with the necessary
meter meters on *e terms ot Section 55 ot the Electricity ACt, Z003
in
f****grEe *e gve yet sue seeunty tes per- seettt *{1ttjef- He- Heetrrerty Aet ~tsf +s may te fequred te- +e pree he
Heter*heters, **enever-eetedtHpoHO de *0{Strike out if meter to be supplied by the consumern
.Details of
Applicant & Premises (where
power supply is requirod):
.
Particulars
1
Application For New Connection
Name of the Applicant/Organization (n Capital
Letters ASIS RANJAN MOHANTY
Name of fatherí husband/Director/Partner/Trustee:(n Son of PRAVAKAR MOHANTY
Capital Letters)
Consumer No.(if application is not for New Connection): NA
PAN NO.
NO.
Purpose of power supply Residential
Category of supply Domestic Single Phase
9 Type of Suppiy Permanent connection
lemporary supply. specily period of requirenent. From to
10 Legal status of applicant. Tenant
11 Nearest Connection No
12 Written permisslon of the laridlord/ownet including legal Yes
heirs tendered
13 Written Permission of Way Leave (Funish t requred) Yes
(Refer to Regulation 15 of the OERC Distribution (Conditions of Supply) Coue. 2019)
Address Detals of the premises fot which how tervice: ConhectoI1 1s applied for / existing connection is required to be
shifted
Nane of Applicant (In Capital Letters): ASIS RANJAN MOHANTY
HozeFat Na KHATA NO-432-607 Plot/Hotdin No. PLOT NO-238-5618
Wi/ inuni*rool A NG Wart n
 AMALAPADA 5TH LANE IN FRONT OF FOREST
Nearest Lancmarn
COLONY
Pin code 759122
District Angul
Postal Address Details tor Communication
15
ASIS RAN.JAN MOHANTY
Name of Applicant (In Capital Letters)
PlotHold1ng No PLOT NO-238-5618
Flat No KHATA NO-432-607
House
Village/Town/Street ANGUL Ward No:
AMALAPADA STH LANE IN FRONT OF FOREST
Nearest Landmark.
COLONY
District ANGUL Pin code 759122
Mobile No/Phone No 9777580347
Email ld:
b. The following are myour electrical installation to be fixed in the premises:
Item Load Per ltem (Watts) No Of Items Load
Tube Light
LED Tube light Lamnp
LED Tube light LampP
Incandescent lamp
540
Table Fan Cellng Fan (36)
Air Circulator
8
Ceiling Fan (48)
Ceiling Fan (56)
280
Exhaust Fan
Music system A
Television (Portable)
Television 123 125
Mixie/Grinder 0
Electric Iron A50
Fridge (Single door) 100
Fridge (Double door) 12 12
Cooler
170
Heater (for cooking) according to physical availatilty
10
Heater (tor cooking) according to physical availability
1500
Heater (tor water heating)
1000
Heater (for water heating)
1500
Microwave oven
Microwave Oven
Washing machine
340
Kitchen Exhaust Chimney
Rqua qUard ilter m/c
0
Fut cong.tioner (1 Ton)
1000
I f Cond tioner (1.5lon)
1500
Geyser 500
Geyser (Instant 2000
Pump Set 313 375
Personal Computer with Monitor
100
Printer
Each light point as 60
Others (if any)
kW): 2.0000 KW
The Total Load applied for (in
c. List of Documents required
Proot submitted along with this application torm
dentity
If Applicant is a person(Tick any one
Proot of ownership ot occupancy of premises tor which clectricity
connection is required.
Proof of current address
Any other document as applicabie (Please specity) Test Documents
Note:
the connected load/ contract demand to be notified
to the licensee and permission obtained betore effecting such
a. Addition OmisSion o
changes General purpOse
tne load snOwn above shall De considered tor Domestic anc
D. In case ot non-avaiability or räted capacity of any item,
category ot consumers
meter himselt ' herselt from the approved vendors of the icensee
c. The consumer shail have the option to procure by
NO
7. Any electncity dues outstanding in licensee's area of operation in consumer's narme:
tor the premises for which connection applied1 NO
8. Any electnicity dues outstanding
corisumer assOCiated as an Owner Partner
9. Any electricity Cues outstanding with the lhcerisee against any ifn wth which the
is
Director NO
Director or Managing
Contractor, as the case may be.
10. Repot of the Electrical Inspector/Licensed is no existing connection in applied premises
Connection. W e heréby declare that there
11. In case of New Entrance or my applied prenmises
In c a s e ot Additional Connection,
that we nave
We hereby declare seperate Dwelling and
12.
Lskone2
Signature ot the corisuret
case of tenant applying 1or power suppIy

ator n t signature in
Name
t) Owner
(i) Tenant
of ownership/ocCupancy ot premises and proof of current address. the following
Note: Apart from documents for identity proof. proot
documents shall be attached with the application torm
authonzaton in the name of the applicant for signing
firm- The applicant shall turfnisth the partnership deed and an
1. In case of a partnership
tne requisiuon torm and agrecment
shall furnish a Memorandum and Articles of Association and Certificate of
2. In case o' Public and/or Private limited Company T h e applicant
incorporation along with an authorization in the natne or the applicant tor signing the reqursition torm and agreement,
3. Other documents applicable only tor select consumer categorieS
name ot the applicant tor signing
authonzation in the
partnership firm- Ihe applicant shall turrnisth the parthership deed and an
B. In case o' a
the requis.tion form and agreement:
ASsociat:on and Certficate of
applicarnt -The shall furnish a Memorandum and Articles o'
c a s e of Publc
B. In or Private limted Company
and
in the name ot h e applicant tor siging the fequisition form and agreement
incorporaton aiong with a n autiorzason
C.Oher documents applicable only 'or solect consuner categone
comsumers: Valic Industria" License, ' applicabe
ndurria' A5o a
i c e fon copeten! goormm et ior ube we.s requiico