Application for Service Connection - Cescoorissa.com

1 FORM-1(Free of Cost.)CENTRAL ELECTRICITY SUPPLY 245e-mail 79 Mob.:101112 Purpose of availing Service ConnectionDomGPSPIO thersName of the :-. of receiving officer CENTRAL ELECTRICITY SUPPLY UTILITY OF ODISHAA cknowledgementReceived Service Connection Application having registration from Sri/ of .. For 3-ph/Single Phase/ Dom/GPS/PI/Others electricity Connection in complete & official Seal17 Status of applicantOwner / Tenant18(Strike out whichever is not applicableDistance (in metre) from nearest Pole to Meter BoxNot KnownIf tenant, whether consent of owner is obtained?)

2 Yes / No15 Whether Phase Addition / OH line / Pole is required for effecting Service ConnectionYes / No16 Nearest Electric Pole Cons. Phase/3 PhaseTotal connected Load 6 Address of Premises (where supply is required) Location DetailsPlot Town/ No:-8 Permanent Address (with Land phone no, if any) (If different , where supply is required).Address for communication (with Land phone no, if any)Pin:Mob:-Pin:Area/ Sahi/ SectorName of Ele.

3 Of the Date3 Name of the applicant/ ConsumerCon. No.(If existing consumer) Application for Service Connection (For Non-Industrial LT Consumers)1 Please Tick ( )New Service ConnectionTemporary ServiceDate of Connection --Revising Connected LoadOwnership ChangeOthers (Specify)Re-effecting ServiceOffice UseCon NoConnected Load (in kW)PurposeTariff CENTRAL ELECTRICITY SUPPLY UTILITY OF ODISHA Head Office: IDCO Towers, 2nd Floor, Janpath, Bhubaneswar 751 022 Phone no: 0674-2541575, Fax No: 0674-2543125 Website.

4 / Space for Photograph192021222324. The following are my/ our Electrical installation to be fixed in the of AppliancesNo. of PointsWattage of light2 Incandescent lamp3 Table fan / Fan (36")4 Fan (48")5 Fan (56")6 Air Circulator7 Music System8 Television9 Mixer Grinder10 Electric Iron11 Fridge12 Cooler13 Heater for cooking (according to physical availability)14 Heater (for water heating)15 Microwave oven16 Washing machine17 Kitchen Exhaust Chimney18 Aqua guard water filter19 Air Conditioner (1 Ton)20 Air Conditioner ( Ton)21 Geyser22 Pumpset( )23 Personal Computer/ Monitor & Printer24 Industrial appliance25 Other item (if any)

5 My Connected demand is .. :-Date:-Office Seal (incase of Application by firms/establishments)Signature of the applicantName-I/We hereby request you to supply Electrical energy to the premises hereinafter described. I/ We am/are the owner/lawful occupier of the premises at Sl. In which supply of electrical energy is now / We agree to take supply for TWO YEARS to utilize the energy for General purpose/ Domestic purpose/PI only. Thereafter Agreement shall so continue unless terminated by either of the parties after giving one month's We agree to pay for the Service Connection and other dues including the security as may be payable and shall also pay the charges, surcharges, electricity duty in accordance with the OERC Distribution (Conditions of Supply)

6 Code-2004 provided that annual sum payable individually by me/ us under the provision of section 45 of the electricity Act, 2003 shall not be deemed to be part of the minimum monthly charges. if any, payable under Regulations 84 and 85 of the OERC Distribution (Condition of supply) code, / We have obtained and perused a copy of OERC Distribution (Condition of supply) code,2004 and understood its contents and hereby undertake to observe and comply with the terms and conditions stipulated therein to the extent they are applicable to me/ further require you to supply me/us with the necessary meter/ meters on hire in terms of section55 of the Electricity I/We agree to give you such security (as per Section 47(1)(b) of the Electricity Act,2003) as may be required for the price of the meter/meters.

7 Whenever called upon to do so. (Strike out if meter to be supplied by the consumer).i) Addition or omissions to the connected load/contract demand to be notified to the licensee and permission obtained before effecting such ) The wattage against Sl. No.(24) above may be estimated as stated above (In case of non-availability of rated capacity of any item, the load shown in Annexure-II shall be considered). Annexure- I CENTRAL ELECTRICITY SUPPLY UTILITY OF ODISHA CHECK-LIST-FOR CONSUMER 1. Application Form, Form I.

8 2. One Passport photo. 3. Xerox copy of Money Receipt against deposit of processing fees. 4. Copy of the Treasury Challan towards deposit of inspection fees of Electrical Inspector / copy of Money Receipt, if deposited in CESU. 5. Attested copy of land document. (Patta/Dalil/Affidavit) where power supply is to be effected. 6. Photo identification for urban consumers like Ration card, Voter ID card, Driving License, Pan Card, Pass Port etc. 7. Copy of the Approved Building/ Site plan from local bodies/ Development Authorities like BDA / CDA/ PKIET etc.

9 8. Indemnity Bond If applicant is not the owner of the premises occupied by him (for BMC/CMC/BDA/CDA area approval allotment from the concerned authority along with I-Bond is required. 9. Xerox copy of previous month bill in case of subsequent Service connections for verification of no dues. 10. Test certificate from a licensed Electrical contractor before effecting power supply. Test Certificate (Format) It is hereby certified that the installation described above has been tested.)

10 The Earth reading taken at two earth terminals The entire installation conforms to relevant standards. Name & Signature Seal & License No. of the Electrical Contractor. 11. Consent in the case of Application by Tenant (Format) being registered title holder and the absolute owner of property located (local body) do hereby give my consent to to avail Service Connection from CESU in his name as consumer at the above premises.