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Haryana Electricity Connection Application

The document is an application form for a new electricity connection from UTTAR HARYANA BIJLI VITRAN NIGAM LIMITED, submitted by an individual named Satveer Singh on 30/06/2025. The application includes details such as the applicant's identity proof, premise information, and load requirements. The applicant has declared the accuracy of the information provided and agreed to the associated rules and regulations.

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133 views2 pages

Haryana Electricity Connection Application

The document is an application form for a new electricity connection from UTTAR HARYANA BIJLI VITRAN NIGAM LIMITED, submitted by an individual named Satveer Singh on 30/06/2025. The application includes details such as the applicant's identity proof, premise information, and load requirements. The applicant has declared the accuracy of the information provided and agreed to the associated rules and regulations.

Uploaded by

r6800s
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

UTTAR HARYANA BIJLI VITRAN NIGAM LIMITED APPLICATION

FORM FOR ELECTRICITY CONNECTION

(1) Office Details [To be filled by office or system generated based Area input ] :
Operation Sub-Division Application Number Date of Application
No.I Rohtak R41-625-641 30/06/2025
(2) Application For New connection
(3) Category of Supply NDS
(4) Type of Supply: Permanent
(5) Applicant Particulars
(a) Type of Applicant Individual
(b) Name of the Applicant [person/firm/Company/trust] SATVEER SINGH
(c) Name & Designation of Authorized Signatory in case of Companies NA
(d) Name of Father/ Husband/Director/Partner/Trustee MOHANDER SINGH
(e) Identity Proof of the Applicant ADHAAR CARD
(f) Mobile No. 99******99

Premise Details where connection is required


Plot /House/Flat No. JSS SQUARE SHOP NO 2 Sector/Colony/Street OPPOSITE BAMAL
HOSPITAL
Village/Town/City ROHTAK Landmark/neighbor NEAR MOHAN PETRO
PUMP
Pin 124001 Property ID 1HKM65M1
MobileNo 99******99 Email RA****@G****.COM
Address JSS SQUARE SHOP NO 2 OPPOSITE BAMAL HOSPITAL ROHTAK NEAR MOHAN PETRO PUMP
124001

(6) Applied Load Details:


Connected Load [KW] Contract Demand [KVA] Purpose of Supply
5.00 N.A. FOR OFFICE USE ONLY
(7) Details of Connection on the same premise/property/other connections in the name of Applicant
Account Holder Account Address Category Connected Load [KW] Contract Demand
Number [KVA]
NA NA NA NA NA NA
(8) Option of Consumer to Supply Meter & Metering Equipment : No
(9) Declaration by Consumer : I/We hereby declare that
(a) The information provided in this application is true to my knowledge.
(b) I/We agree to abide by all the Rules & Regulations of the Nigam & HERC.
(c) I/We will deposit electricity dues and old dues if any , as per the applicable electricity tariff and other charges failing which
the supply of electricity will be liable to be disconnected.
(d) I/We will own the responsibility of security and safety of the meter, cut-out and the installation
(e) I/We am/are the owner(s) / legal occupier of the premises in which supply of electricity is hereby
requisitioned for which true copies of documents are submitted.
(f) That the internal wiring at the premises has been got executed and tested by a Licensed Electrical Contractor/ designated
officer of the Government and test certificate is available with the applicant.
Dated:- 30/06/2025
Place:-

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