Application For Low Tension(L.T) Electricity

Date :
21-Oct-2017
* Indicates mandatory details to be provided.
*Applicant Name :
*Father/Husband Name :
*Load Type :
[ Present Address ]
*Address :
*Mobile : *Phone :
*Email ID :
[ Permanent Address ]
Same as present address
*Address :
*Mobile : *Phone :
*Email ID :
*Plot No / House No :
*Road / Street / Lane :
*Ward No :
*Colony :
*City / Town / Village :
*Police Station :
*Post Office :
*District :
*Do you agree for the applied circle ?(If yes, attache the agreement copy) :
*Is it been rented? (If yes, attach the rent agreement copy) :
*Identity Proof ( Present ) :
*Identity Proof ( Permanent ) :
Consumer No Consumer Name Tariff Range Approved Load
( K.W / H.P )
Outstanding
Sl.NoType of AppliancesUnits/W No. of Appliances Load (KW / HP)
1 Lighting Load
  X =
2 Fan
  X =
3 Small Equipment Load
  X =
4 Heater (For cooking or boiling water)
  X =
5 Air conditioner (AC)
  X =
6 Gizer
  X =
7 Water Pump/Motor
  X =
8 Welding Set
  X =
9
  X =
10
  X =
11
  X =
I Accept the
Terms & Conditions