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Name Change Undertaking Form 231209 CC

1) The document is a letter requesting to transfer an electricity connection to the applicant's name from the previously registered consumer's name. 2) The applicant states that they are the tenant, occupant, or owner of the premises where the connection is located. 3) The applicant agrees to submit valid documents to prove ownership/occupancy and to pay any outstanding debts on the account. They also agree to indemnify the company from any future disputes related to the name change.

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Anil Govind Patkar
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405 views2 pages

Name Change Undertaking Form 231209 CC

1) The document is a letter requesting to transfer an electricity connection to the applicant's name from the previously registered consumer's name. 2) The applicant states that they are the tenant, occupant, or owner of the premises where the connection is located. 3) The applicant agrees to submit valid documents to prove ownership/occupancy and to pay any outstanding debts on the account. They also agree to indemnify the company from any future disputes related to the name change.

Uploaded by

Anil Govind Patkar
Copyright
© Attribution Non-Commercial (BY-NC)
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
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To Date:

Reliance Infrastructure Ltd


Santa Cruz (East)
400 055
Affix
Undertaking for Change of Name photograph
here and
sign across
Dear Madam / Sir

Account No.: Meter No.: Note: Please do not staple


the photograph

Customer's Present Registered Name:

Address at which supply is connected:

Pin Code:

I request to transfer the above connection to my name. (Form 16.1 enclosed).

I am the tenant/occupant/owner of the premises. The connection is registered in the name of the
previous tenant/occupant/owner of the premises/in the name of the builder/society.

I have read and understood the procedure for registration for Change of Name as stated overleaf and I
shall abide by the set procedure and submit all true and valid documents.

I am submitting the following documents in support of my ownership/occupancy of the premises.

1)

2)

3)

I state that I am the sole occupant/owner of the above premises for which the abovementioned
meter(s) are connected and the electric supply is used exclusively for the above premises. I also state
they I am not receiving supply at the above premises through any meters.

In case of any false representation on my part or in case of any objection from the present registered
consumer or in case the documents produced by me are not absolutely correct, the company reserves
the right to retransfer the connection in the name of the present registered consumer.

I undertake to make the payment to the company of all debits due and payable with respect to the
present registered consumer that may arise at subsequent date.

I also undertake to keep your company indemnified of any consequences at any time in future, in case
of any dispute on account of the transfer of the above connection to my/our/name/names.

This undertaking will be binding on myself/ourselves and my/our/her executors and administrators.

Yours faithfully

Name: Applicant's Signature


(*Joint signatures in case of multiple Registered Consumers)
Procedure for Registration of Change of Name

December 23, 2009

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