CHANDIGARH ELECTRICITY DEPARTMENT For office use only APPLICATION AND AGREEMENT for....... supply To The .......... CHANDIGARH ELECTRICITY DEPARTMENT ............ I/we hereby agree to take from the Chandigarh electricity department, (herein after referred to as the supplier) at the premises stated below, a supply of electrical energy not exceeding the connected load of my/our installation as below, and I/we here by further agree to pay the said supply in accordance with the relevant tariff and also to pay for all such other proper charges as may become due by me/us to the supplier from time to time at the rate laid down in the standard schedules of service and general charges prescribed by the supplier and I/we further agree that I/we will if and when required by the supplier to do so, lodge with the local office of the department a deposit ,calculated as prescribed in the abridged conditions of supply prescribed by the supplier. And I/we here by declare that the said conditions of supply including schedules of tariff, service charges and, general charges have been perused by/read to me/us and I/we agree to be bound by them as also the provision of clause VI of the schedule of the Indian electricity act, 1910. I/we further required to supply me/us with the necessary metre/metres on hire in terms of section 26 of the Indian electricity act 1910. I/we agree to give you such security as may be required for the price of metre/metres when ever called upon to do so. Description of premises: House no _______________ locality ________________ town ______________ I/we also declare that : (i) I/we am/are owner/landlord of the promises. (ii) My/our landlord agree to my/our taking the said supply and his written consent enclosed herewith. (iii) I/we am/are the lawful occupiers (s) of the premises but it has not been possible for me/us to obtain consent of my/our landlord and I/We hereby agree to keep indemnified and harmless the supplier against all claims made and action and proceedings taken by the landlord or any person claiming through or under him by reason of the giving of electric connection by the supplier to me/us. Application ..... Date of receipt ...... Connection No...... Schedule of energy consuming apparatus: Lamps Fans Plugs* Appliances: Heaters, Cookers, Refrigerators, etc Motors 1 2 3 Description Wattage Total Description Wattage Total Watts No. B.H.P Each Total K.Ws. * The plug points for lamps, fan, etc, to be shown under col. 1 and those for appliance under col.2. Total connected load of the above installation ______________________ watts/KWs. Signature of applicant __________________________________________________ Present address ________________________________________________________ Signature and address of witness __________________________________________ (FOR OFFICE USE ONLY ) Pressure Of Supply Is _____________________________ Volts Accepted on behalf of the Chandigarh electricity department For ______________________________ watts/killowats. Chandigarh Electricity Department. CHANDIGARH ELECTRICITY DEPARTMENT For office use only NOTICE The applicant should hand over this application to the local office of the department. REQUISITION FORM SUPPLY OF ENERGY [ Under clause VI(5) of the schedule to the act] Application no.__________ Date of receipt.__________ Connection no.__________ To The Chandigarh Electricity Department Sir, I/we here by require you in accordance with clause VI of the schedule to the Indian Electricity Act,1910 within one month or within such longer period as the Electricity Inspector may allow, from the date of this requisition to supply energy for the premises owned/occupied by me/us and situate within the area of supply specified in the scheme _________________________________________________________________ I/we further require you to supply me/us with the necessary meters on hire in terms of section 26 of the electricity act , 1910. I/we agree to give you such security as - 2. Applicants Name__________________________________________________ Occupation/designation ____________________________________________ Description of premises.____________________________________________ House no and or __________________________________________________ Name of the premises.______________________________________________ Street______________Locality_________________village/Town___________ Owned /tenanted by _______________________________________________ ` Written permission of the landlord tendered______Yes or No./Not applicable 3. The following are my/our requirement : A. Domestic or Residental No of Points Wattage Total wattage (a) Light and Fans (b) Heating and small power B.Commercial (a) Light and Fans (b) Heating and small power C.Industrial power Motor and/or No of points H.P. and Total H.P purpose Apparatus KW and KW (a) low voltage (b) Medium voltage (c) High voltage D. Other Purpose Total connected load applied for _________________________________ 5. This requisition is for (1.) A new Service, The nature and address of the consumer whose services is to be tapped________________________________________________ His Account No, is____________________________________ (2.) An extension to my installation (A/C No. ___________________) (3.) A reconnection of Account No. ____________________________ (4.) A change of Name from ____________ Account No. _______ (5.) The system of wring will be (6.) The wiring will be carried out by : Name _______________________ Address __________________ Applicant's Signature ____________________________________ Present Address ________________________________________ Dated the _________________ day of ___________________ 19 Note :- The applicant is requested to complete the clause referring to this requisition and to strikeout the clauses which are in applicable. 2. Under clause VI(i) Ist provision of Schedule to the Indian Electricity Act, 1910. the Department shall not be bound to comply with any such requisition unless and until the person making it required by the Licensee so to do, pays to the licensee the cost of so much of any service line as may be laid down or placed for the purpose of supply upon the property in respect of which the requisition is made, and of so much of any service line as it may be necessary for said purpose to lay down or place beyond ane hundred feet from the licensee distribution the main although not on that property. ACKNOWLEDGEMENT Received the application of _____________________ on _______________as per Serial No. ___________________ which should be quoted in all further correspondence. Signature and Designation of the Official receiving the Application.
