BANGALORE ELECTRICITY SUPPLY COMPANY LIMITED

A FORM OF REQUISITION FOR LT POWER SUPPLY UPTO 66 H.P/50KW UNDER

REGULATION 7 OF E.S.R.1988.
NAME OF THE APPLICANT/ FIRM:.
POWER SUPPLY REQUIRED AT (ADDRESS)

FOR OFFICE USE ONLY

SERIAL NO:
ISSUED TO SRI / M/s..
ISSUED ON.
REGN FEE PAID Rs.. Rt. No...... DATED...
Office stamp. Assistant Engineer, Elecl.,
Technical section.
R. R. NUMBER ASSIGNED:.
DATE OF SERVICE:..

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THIS APPLICATION IS NOT TRANSFERABLE

BANGALORE ELECTRICITY SUPPLY COMPANY LIMITED
FORM OF REQUISITION FOR SUPPLY OF ENERGY TO LOW TENSION POWER
INSTALLATIONS UPTO 66 H.P/50KW UNDER REGULATION-88.

TO:

1. The Executive Engineer, Elecl.,

2. O & M Division,
3. The Asst. Executive Engineer, Elecl.,
4. O & M Sub Division,
5. Bangalore Electricity Supply Company Limited,
6. ..
Dear Sir,
I/ We hereby request you in accordance with the clause VI of the schedule of the Indian Electricity
Act 1910, within one month or within such longer period as the Electrical Inspector may allow
from the date of this requisition to supply energy to the premises owned / occupied by me / us
and situated within the area of supply.

I / We further request you to supply me/ us the meter necessary in terms of section 26 of the
Indian Electricity Act 1910. I/ We agree to give you such security as may be required for the
meter/ meters whenever called upon to do so. I/ We have also gone through the instructions
obtained in this form and I /We have attended all the necessary documents along with this
application.

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1. Name of the applicant / company.

2. Name of the authorized signatory
3. Fathers name :(In case of ownership company.)
4. Age of the applicant:.years
5. Occupation/Designation
6. Power supply required at(address)
..

7. Type of Ownership: The premises is Owned/ Leased/ Singly owned/ Partnership/ Private
company/ Public company.(documentary proof to be produced, and if partnership MOU to be
enclosed)

8. If licence from appropriate authority obtained: Y E S / NO.(LICENCE not required in industrial

area of KIADB/ KSSIDC)

9. Premises located in : industrial area of KIADB/ KSSIDC/ Private layout/ Municipal/ corporation/
Village panchayat area.

10. Is the connection new/ additional to old installation:.

11. Details of the power required : Single Phase HP + KWs Three phase
. HP + ...KWs.

12. Total electrical power required:..HP + .KW.

13. Sister concerns, if any:..
14. Address for correspondences till the power supply
.is arranged: Telephone No.
. STD code..

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15. Details of enclosures:

a. Site plan with proposed location of the meter Board.
b. Latest Tax paid receipt.
c. License/permit/NOC from local Body.
d. Route map to locate the Premises.
e. If lessee, registered lease agreement.
f. Environmental clearance certificate wherever applicable

Certified that I/ We have gone through the instructions given to the applicant in this brochure and
have filled up all the columns.

Certified that the above information furnished by Me/ Us are true and correct.

I/ We/ are also aware that I/We are solely responsible for the incorrectness if any in the above
declaration. If any of the information furnished above is false, KPTCL may disconnect power
supply without notice.

I/ We / are agreeable to execute the works as estimated on self execution basis.

Dated on .

Place

Signature of the applicant/authorized signatory

(Stamp of the firm)

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Bangalore Electricity Supply Company Limited

SERVICE CERTIFICATE
This is to certify that the following installation is serviced today, the .by the
Corporation.
The details are as under:

1. Name of the customer:

2. Address of the installation:
3. RR. No. :
4. Sanctioned Load
5. Tariff Applicable:
6. Meter reading date:
7. Next to RR No:
8. Ledger NO:
9. Capacitor provided..KVAR
10. Initial security deposit Rs: Rt No and date ..
11. Meter security deposit Rs:.Rt. No. and date....
12. Development charges Rs:.... Rt No. and date..

For Bangalore Electricity Supply Company Limited.

Office Stamp

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