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FORM NO.
A-1
To
The Maharashtra State Electricity Board,
__________________________(Office)
- I/We
here request you to supply electrical energy to the
premises owned/occupied by me/us hereinafter described.
- I/We
hereby agree to keep supply and pay for the side energy
security as may be demand in accordance with the rates and
conditions of supply of the board in force from time to
time and further declare and agree to take supply of energy
for the under mentioned purpose for my/our benefide use
for a period of not less than two years from the date of
commencement of supply.
- I/We
also undertake to supply within three months from the date
the board intimates that it is the ready to supply to our
premises failing which I/We undertake to pay the board the
minimum charges as may be applicable
- In
the event of death of individual/desolutions of amulgamation
of
the company I/We hereby nominate Shri/Smt./Sau._________________________________________
________to receive or adjust the deposit outstanding in/our
name.
- This
requisition is for:-
a) A new service, b) Re-connection, c) An alteration to
may existing installation, d) A temporary service, e) A
change of name Shri____________________________
- Description
of premises
House
No. Land Survey No.
Street
District
:- Town/Village
Owner's
Name :-
Owner's
Addtress :-
| Incandescent
Lamps |
Fans
|
Plugs
Heater etc. |
Motors
|
Total
demand |
| No. |
Wattage
of each |
No. |
Wattage
of each |
No. |
Wattage
of each |
No. |
BHP.
of each |
KW/HP |
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9. My/Our requirements are as
follows :-
The
wiring will be charged out by :-
Name
of the licensed wiring contractor :-
His License No.
His Address :-
Date :- (Signature
of applicant)
Name of applicant:___________________________
Occupation : _______________________________
Address:_______________________________________
_______________________________________
(Strike
out items not applicable).
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