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GOVERNMENT OF JAMMU AND KASHMIR ELECTRICITY DEPARTMENT Application form for requisition of Low Tension Power supply

The Executive Engineer (Electrical)/Assistant Engineer (Electrical)/Officer-in-charge/SubSection. Electricity Department, Government of Jammu and Kashmir, ................................................. (Local Office)

I/We hereby require you, in accordance with Clause VI of the Schedule to the J&k Electricity Act, 2006 within one month or within such longer period as the Electrical Inspector may allow, from the date of this requisition to supply energy for the premises owned/occupied by me/us and situated within the area of supply. I/We further require you to supply me/us with the necessary meter/meters on hire in terms of Section 26 of theJ&K Electricity Act, 2006, I/We agree to give you such security as may be required for the price of the meter/ meters, whenever called upon to do so. 2) Applicant's name. (In Block Letters): Occupation/Designation Description of premises. House No. and or Name of the premises. Owner's name............................................................................................. Owner's address................................................................. Street...............Town/Village.................Taluka.District................................. A) Domestic or Residential................. (a) Lights & Fans ...................... (b) Heating & Small Power .. No. of points Wattage Total Wattage

B) Commercial (a) Lights & Fans ...................... (b) Heating & Small Power . C) Industrial Power Motor & or / /apparatus. (a) Low Voltage........................ (b) Medium Voltage................. (c) High Voltage.......................

No. of Points

H. P. & K. W.

Total

Purpose

Total connected load applied for Watts/Kilowatts H.P. 5) The following are my/our requirements. (1) A New Service. (2) A sub-service from an existing service: The name and address of the consumer whose service is to be tapped His service No. is (3) An extension to my existing installation from Service No. (4) A re-connection of Service No. ........................ (5) A change of name from Service No. (6) The system of wiring will be (7) The wiring work will be carried out by Wiring Contractor's Licence No.: Name: Address: Applicants signature: Present Address: Date:Theday of200

I/We hereby declare that l/We desire to have and agree with the Electricity Department to take supply of energy for the above mentioned purposes for a period of not less than two years from the date of commencement of the supply and to be bound to the provisions of clause VI of the Schedule of the J&K Electricity Act, 2006, and by the Electricity Department's charges, appropriate tariffs applicable to me/us and Conditions of Supply as are from time to time in force

One & half Rupee Stamp

Applicant's Signature

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