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16/02/2017 SV/TV/CTA FORM

HINDUSTAN PETROLEUM CORPORATION LIMITED UNIQUE CONSUMER ID: 2 1160 9038 0000 0790
ID CODE DOCUMENT TYPE
(A GOVERNMENT OF INDIA ENTERPRISE)
1 Subscription Voucher
REGISTERED OFFICE: 17, JAMSHEDJI TATA ROAD

MUMBAI-400 020

DOC NO. DATE FILLING PLANT NAME PLANT CODE


1033761 05/01/2017 RAJAMUNDRY LPG PLANT 12731
CONSUMER NO. DEALER CODE DEALER'S NAME AND ADDRESS
50485 19579330 RAJAHMUNDRY GAS COMPANY
D.NO. 75-3-3 GANDHIPURAM RAJAHMUNDRY
RAJAHMUNDRY,ANDHRA PRADESH (OLD) 533103
CONNECTION REGISTRATION EQUIPMENT CODE NOS. AMOUNT
TYPE NATURE NO. 8938 CYLINDER 036 1 1450
3 1 DATE 03/01/2017 REGULATOR 047 0 0.00
AMOUNT IN WORDS One Thousand Four Hundred and Fifty Rupees Only TOTAL 1450
CONSUMER NAME GOVINDARAJ ANAND
CONSUMER ADDRESS FLATNO. 107, MURALI MANSION AVA ROAD, NEAR LAKSHMI DEVI
TEMPLE
RJY
RAJAHMUNDRY,ANDHRA PRADESH (OLD) 533103
OLD PARTICULARS DOCUMENT NO. DATE
DEALER CODE ORIGINAL SV 1033121 01/09/2016
FILLING PLANT CODE CURRENT SV
CONSUMER NO. ADDL. SV 1033761 05/01/2017
OIL COMPANY TV/CTA/SVCD
1. Hindustan Petroleum Corporation Limited (hereinafter called the corporation) loans to the consumer and the consumer takes on loan from the corporation, cylinders and
pressure regulators (hereinafter collectively called "the equipment) required for the supply of the corporation's product viz. "HP gas" (hereinafter called the gas).
2. The consumer shall deposit with the corporation an amount in accordance with the corporation's tariff in force from time to time as security for the due fulfillment by the
consumer of his obligations hereunder. The corporation shall be under no obligation with regard to the manner of use or disposal of the funds received as deposit from the
consumer shall it pay to the consumer any interest thereon.
3. The consumer shall remain responsible to the corporation for the safe custody of the equipment and shall not sell, mortgage or otherwise dispose of the equipment or
create any interest therein or charge thereon in favor of any party.
4. The consumer shall not remove the equipment to any address other than that shown on the obverse thereof without obtaining the prior written permission of the
corporations dealer concerned (hereinafter called the dealer). Further, in the event of the consumers departure from the area serviced by the dealer, he shall return the
equipment to the dealer.
5. The consumer shall not attempt to repair the equipment or cause or permit anyone other than the corporation to do the same and shall permit the dealer to remove the
equipment for repairs from the consumers premises. The consumer shall not exchange the equipment with or have the cylinder refilled by anyone other than the corporation
or the dealer, nor shall use the cylinder for any purpose other than as a container for the gas supplied by the corporation.
6. The consumer shall be liable for any loss of or damage to the equipment or any part thereof and shall reimburse to the corporation the value of the missing or damaged
equipment or part thereof in accordance with the corporations tariff in force on the date of reimbursement.
7. The corporation and/or the dealer shall not be responsible for any failure and/or delay in supplying the gas to the consumer if such supply has been delayed/hindered or
prevented by any circumstances whatsoever be the control of the corporation and/or the dealer.
8. Any sale by the dealer to the consumer of the gas appliances and their parts and accessories including rubber tubing/suraksha hose used for connecting the appliances to
the equipment shall be effected by the dealer on his own account and his own right.
9. The consumer shall use only appliances of a type approved by the ISI or the corporation.
10. All necessary installation work including the connection/disconnection of cylinder to/from the appliances and/or pressure regulator and the work of repairs to appliances
and the replacement of rubber tubing will be carried out at the customers expense and on his own responsibility by the dealer and not on behalf of the corporation. The fact
that the consumer is supplied HP gas shall not be deemed to impose any liability on the corporation with regard to the fitness or otherwise of the installation and/or repair
work. The corporation and/or the dealer and/or the person authorized by either or them shall, however, have the right to inspect the installation at any time and, if considered
necessary, for reasons of safety, to refuse to supply the gas to the consumer.
11. The corporation shall not be liable for any loss or damage caused to any person or property as a result of the installation and/or the use of the gas by the consumer. In the
event of any accident involving the customers installation, he shall forthwith inform the dealer.
12. The corporation as well as the consumer shall be at liberty to terminate the contract at any time by giving 15 days', notice in writing. On termination of this contract the
consumer shall forthwith return the equipment to the corporation and/or the dealer, thereafter refund the balance of the deposit made by the consumer with the corporation
after deducting therefore such amounts, if any, as may be due to the corporation
13. As per gazette of India notification dated 10th September 2009 on LPG control order, a "household" means a family consisting of husband, wife, unmarried children &
dependent parents living together in a dwelling unit having common kitchen can have one LPG connection in their "household" & in case if such family is having or avails a
piped natural gas connection of any company then the LPG connection will be surrendered within 60 days failing which HPCL will cancel the LPG connection or Refills can be
taken at Non Subsidised rates.
14. The consumer shall pay the stamp duty, if any, in respect of the subscription voucher
For subscription voucher only (Deposit will not be refunded without production of this document)
HP gas consumer certificate: I/we acknowledge having received from HPCL the quantity of HP gas cylinder(s) and pressure regulator(s) mentioned in the nos. Column hereof
on loan on the conditions which have been set out overleaf and by which I/we agree to abide. I/we have also received the HP gas instruction card.
HP gas distributor's certificate received on behalf of Hindustan Petroleum Corporation Limited, the amount mentioned above being the deposit of HP gas cylinder(s) and
pressure regulator(s) loan in accordance with company's tariff.
For termination voucher only
HP gas consumer's certificate: I/we declare that I/we have received the amount as mentioned above being the balance of the amount of deposit to my/our credit in
accordance with the conductors of supply. HP gas distributor's certificate: equipment received in good condition. This TV is valid for one year.
Regulator Serial No. : ASHKIN E348539
This form has been signed and certified using a Digital Signature Certificate

Signature Not Verified


Digitally signed by DS HINDUSTAN
PETROLEUM CORPORATION LTD 1
Date: 2017.02.16 10:53:10 +05:30
Reason:
Location: Mumbai