Scribd
Upload
40 views1 page

Annexure IV

This document is an application form for changing the name of a registered consumer for a service connection. It requires details such as the current name, consumer category, and address, along with necessary supporting documents. An acknowledgment section is included to confirm receipt of the application and provide a reference number for future correspondence.

Uploaded by

Amrurta joshi
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
40 views1 page

Annexure IV

This document is an application form for changing the name of a registered consumer for a service connection. It requires details such as the current name, consumer category, and address, along with necessary supporting documents. An acknowledgment section is included to confirm receipt of the application and provide a reference number for future correspondence.

Uploaded by

Amrurta joshi
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
You are on page 1/ 1

ANNEXURE-IV

Application form- Change in Name of Registered Consumer

1. Service Connection No._________________________


2. Name of Registered Consumer (at present) _______________________________
3. Consumer category___________
4. Contracted load __________
5. Address: ______________________________________
______________________________________
______________________________________

Telephone No ______________________

6. Name of the person in whose name connection to be changed


(in CAPITAL LETTERS) ____________________________________________

Note: The following documents are attached with the application form: (Tick whichever
applicable):
1. Copy of latest bill duly paid.
2. Proof of ownership/legal occupancy of premises.
3. No. Objection Certificate from the existing consumer if available/possible.
4. Registered deed/Succession certificate/ (if any other document, please specify).

Date: __________________ Signature of the Consumer

Place: __________________ Name: ________________________

Contact No. _________________ Email-Id ______________________________

ACKNOWLEDGEMENT

Application form of Service Connection No. ________________ at present in the name


of _________________ (name of applicant) has been received on ________________
(date) for changing the name of consumer to _________________________________

In this regard, the consumer is given a reference No _______________to be used for


all future correspondence.

Signature/Seal of Licensee's representative

Name and Designation:

You might also like