FORM-III FORM FOR LODGING COMPLAINT FOR DISCONNECTION AND RECONNECTION OF POWER/PROBLEMS IN METERING / DISCREPANCIES IN BILLS To be filled in by Consumer Sub Division :_________ Complaint Ref. No._______ (to be given by HPSEB) Consumer Account No 1. Name & full address of the complainant 2. Brief Description of complaint 3. Date of complaint 4. Any other information Signature of Complainant/Consumer Tear off (To be perforated) ........................................ ACKNOWLEDGEMENT TO BE FILLED IN BY THE HPSEB AND HANDED OVER TO THE CONSUMER Date: 1. Complaint Ref. No. (to be given by the HPSEB) 2. Applicant's name 3. Received on date 4. Complaint received by 5. Brief detail of complaint 6. Information supplied/provided to consumer, if any 7. Target date to resolve the complaint Signature of Authorized Officer Designation: SEAL:
