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  • ...... Form Rahul

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    Raj Verma
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    axaxaxaxa

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    ......form rahul

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    axaxaxaxa

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    5 views5 pages

    ...... Form Rahul

    Uploaded by

    Raj Verma
    axaxaxaxa

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 5

    5/23/2015

    WelcometoIGL

    INDRAPRASTHAGASLIMITED

    ReferenceNo.:

    (JointVentureofGAIL(India)Ltd.,BPCL&GovernmentofNCTofDelhi)

    DateofRegistration:

    2015383358
    09/05/2015

    IGLBhawan,PlotNo.4,
    CommunityCenter,Sector9,R.K.Puram,NewDelhi110022

    APPLICATIONFORMFORREGISTRATION&SUPPLYOF
    DOMESTICPIPEDNATURALGASCONNECTION
    (TobefilledinBlock/CapitalLettersOnly)
    I/WewishtoregisterfordomesticPipedNaturalgasconnectionasperdetailsmentionedbelow:
    NAME:Mr./Ms/Mrs.:

    rakeshvarma

    Father's/Husband'sName:

    late.shmanoherlalvarma

    Address:HouseNo.:

    houseno360

    StreetName:

    SAINIKVIHAR,PITAMPURA

    State:

    NEWDELHI

    Pincode:

    110034

    Landline(Office):

    (Residence):

    MobileNo.:

    9711000996

    Email:

    sunnydell321@gmail.com

    TypeofOwnership,Pleasetick()

    Owner

    Rented

    IfRented,pleasesubmitNOCtobeissuedbythelawfulownerofthepropertyasspecifiedbelow:
    PAYMENTDETAILS:(NonRefundableadditionalcharges,ifapplicabletobepaidoncompletionoftheinstallationasperClauseNo.2
    ofCustomers'Rights&Obligations)
    PayOrder/DD/ChequeNo.

    Date:

    Drawnon:

    favoring"INDRAPRASTHAGASLIMITED"

    Amount:

    towardsRefundableSecurityDepositasperthetermsandconditionsstatedoverleaf.

    Date:

    Yours'sFaithfully

    PAYMENTINCASHIS
    NOTACCEPTED
    (SignatureoftheApplicant)

    NOOBJECTIONCERTIFICATE(TobeFilledbythelawfulOwner)
    (Applicableonlyifthepremiseisrented)

    ThisistocertifythatI,Mr./Ms./Mrs.

    amthelawfulowneroftheabovementionedproperty.

    Ihavenoobjection,ifthetenantofthepropertyasmentionedabove,availsdomesticPNGconnectionfromIndraprasthaGasLimited
    Name:

    Date:

    PermanentAddressofOwner:
    Landline(Office):

    (Residence):

    MobileNo.:

    Email:

    ProofofOwnership(asenclosed):
    Signature:

    http://www.portal.igl.co.in/wps/PA_UCnectionPrintForm/common/UsrConnectionStatus.jsp?&Rf=2015383358

    1/5

    5/23/2015

    WelcometoIGL

    http://www.portal.igl.co.in/wps/PA_UCnectionPrintForm/common/UsrConnectionStatus.jsp?&Rf=2015383358

    2/5

    5/23/2015

    WelcometoIGL

    http://www.portal.igl.co.in/wps/PA_UCnectionPrintForm/common/UsrConnectionStatus.jsp?&Rf=2015383358

    3/5

    5/23/2015

    WelcometoIGL

    Print

    http://www.portal.igl.co.in/wps/PA_UCnectionPrintForm/common/UsrConnectionStatus.jsp?&Rf=2015383358

    4/5

    5/23/2015

    WelcometoIGL

    http://www.portal.igl.co.in/wps/PA_UCnectionPrintForm/common/UsrConnectionStatus.jsp?&Rf=2015383358

    5/5

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