Self Declaration Form
Uploaded by
kundansardar12345Self Declaration Form
Uploaded by
kundansardar12345CONSUMER SELF DECLARATION FORM
I _________
S /o / D/o / w/o applying for a new meter in ICSC hereby
declare the following things:
1. I am the statutorily bonafied owner for the premises for which new service connection is applied for.
2. There is no Electricity charge outstanding on my name or persons of my family anywhere in TGSPDCL
Jurisdiction.
3. All the required documents such as Ownership deed, E.g.:- Tax receipt, copy of registered documents
and necessary approvals are enclosed hereunder to release the supply.
4. Wiring is completed in all aspects and required length of service ire is made available for staff.
5. If the [Link] services is above four, I will apply for the panel board.
6. Meter can be installed outside the house /Verandah in ground floor, service wire drawn is also visible.
7. Perfect earthing was done as advised by your department.
8. No additional infrastructure such as electric pole, lines etc., are required to release the new connection,
which I applied for if required I will pay all the necessary charges, to take the supply after execution of
additional infrastructure.
If any of the above conditions are not satisfied to the TGSPDCL, I will wait and take the supply after
fulfilling all the requirements.
Place:
Date:
Signature of the applicant Name:
Address: