NAME TRANSFER FORM FOR DOMESTIC PIPED NATURAL GAS CONNECTION (To be used only for individual transfer cases only) MAHANAGAR GAS LTD. L™: (TT (Aleit veture of GAL (ria Li. Brith Gas (UK) 8. GM) ‘Regd Omtee ML Hovso,@ 39 Bock, Bandra Kuta Complex, Bandra (Eas), Mumbei 40 051 uavusiagan Consumer Care Office: Mk. Pay & Accounts Buin, Ground Flor Banda Kurta Complex, Banta (East), Mumbai 400051, Undersigned is the new occupier / user of the property stated herein below and hereby request Mahanagar Gas Limited to transfer the ‘ownership of the Piped Natural Gas (PNG) connection bearing CRN ‘& Meter No, My personal particulars and address are given here under. eee aE aa ‘Name (_]Me. []Ms.[_]Mrs. ‘SURNAME, FIRST NAME IODE NAME FATHER MUSBANO'S NAME paw ofan [D)[D|/[][V [YI IZ] occupation [_] FlauRoom No. |_|) Foor! |_| ||] wing L Plot No. ‘Address where PNG is instal (in Block letter) Colony Road Name Location || city PIN Pan No. vee re TILL ma =a [ eseiee aatoara id coarse ‘Reason for Transfer of PNG connection :( 7” Tick Mark any one) 4. Purehase of propery [_] 2. Inhertance of Property Successlon 2 ropery acquired byway of cour onder J Auction Transfer of Tenancy Leave and License Agrewment Lease, [—] 4. Demise of Registered Customer |] 5. Hany ther DETAILS OF TRANSFER CHARGES Rs. cheque No. cheque Date Bank Name & Branch ‘Choque subjectto realization in Mahanagar Gas 1a. Ne, Please note hatin case of lshonaur af cheque, Ra, 200.00 shal be payable by the consumer towards ‘acminisrative charges. This s prejudice to allourrghts IO OBJECTION CERTIFICATE (NOC) FROM THE PREVIOUS GAS CONS! Ea wwe present residing at state that CRN No presently slands in our name, We have No Objection in transfering the above PNG connection in name of Signature ofthe Present Ownet!User cae: IL )/Dl (DAR IL "Name of the Present Owe Place (Sionature shouldbe ori rom the Natonaleedbarkr any other auton) incase rovous owners ramenatmentoned in agreament copy SS We deciare that whatever stated herein above is re and correct and no information has been concealed. I any information provided found tobe incorect ‘Mahanagar Gas Limited shall be eniled to disconnect PNG supply without ary notice. 2. UWe confirm tat UW have read and understood the terms & conditions Cnihe reverse hereot. 3. UWe accept & agree tothe said terms & conditions, as amended from time to time, 4, IWWe agree to sett the unpaid connection related Charges gas consumption ils ofthe previous gas consumer 5. MGL Officer shall have right to reject he application without assigning any reasons there. 6. In ‘supporto this application folowing documents are encloses SEE ‘1. NOC rom the present owner ofthe PNGilodemnfication incase the NOC fom previous owner of PNG not possible. 2, NOC fom thejoint owners incase the property nthe intnamelinderity bond. 5. Copy of sale deedleave and license agreement / lease deed Irelase deedtenancy documenttransfer of tenancy agreementrent receipVcourt tder/suebession certiicae/maintonance paid to cooperative society 4, Incase of Death of previous PNG owner a copy of death coricat, NOC af joint hers fany and Share Cerificate of Co-operative Housing Society attr rom Co-operative using SodetyINOC lem Co-operative Housing Socey. ‘Allinformation provided aboveis true and correc. Signature the applicant pate: LoL. Namecfthe applicant Place eae ens DRS No. Conn, Status : ConvertediNon-converted © Payment status: Full/Part CHECKED BY ~ VERIFIED BY ‘AUTHORISED BY Remark : Arrears checkedAnnexure | “The following terms and conestions wil apply and govern the provision of PNG connection and the supply of Piped Natural Gas (PNG) to the Domestic consumers by Mahanagar Gas Linited. 20 2a 22 23 24 30 aa 40 4a 42 43 44 45 46 54 52 63 54 55 60 61 62 DEFINITIONS : “Application” means duly filed in form submited to MGL by the Consumer / Customer along with Application charges for Piped Natural Gas (PNG) connettion. “Applicant” means a person or individual including Jurstic or Legal person, who submits duly signed and filed in Application for PNG connection. Consumer’ means an applicant who has submitted an application completed in all respects (inclusing Application charges) for supply ‘of PNG for domestic house hold use or an exsing PNG user, whois using PNG. for domestchhousehold purpose “Gas” or “PNG"means natural gas vansported through pipelines in @ CGD Network for consumption by any consumer in domestic, ‘commercial o¢ indus Segments “ML” or “SELLER” means Mahenagar Gas Limited Premises” means the premisesitenement Jhousejfial owned or occupied by the Consumer wherein the PNG is supplied by the SELLER “Tariff Card means a schedule of charges payable to MGL by the Consumer from time tote including securty depostt and sale price of Gas. “Application Charges” means non refundable amount collected from the Consumer / Customer along with the Application for PNG connection towards marketing actives prior to providing PNG supply. “Security Deposit” shall mean interest fre refundable amount collected from the Consumer / Customer at the time of providing PNG connection towards the safe keeping of the equipments installed atthe premises ofthe Consumer) Customer. “Consumption Deposit” shall moan interes ree refundable deposit collected from the Consumer / Customer towards securing prompt ‘and regular payment of Gas consumption charges frm time to time, ‘Words importing the masculine gondor shal, where the context so admits, include the feinine gender and masculine gender. ‘Words importing the singular number shall where the context so admis, include the plural numb, PNG CONNECTION AND SUPPLY : ‘The Gas willbe made available tothe Consumers premises by MGL subject to tochnical and safety feasibly. ML reserves the right to witneraw or disconnect the supply of Gas at any time in the event of any emergency without notice, ‘The submission of he Application along with requisite Application charges tothe SELLER shal be construed as full understanding of the fers and condtions and is implications by the Consumer and it shall be treated as a binding contract between the SELLER and the ‘Consumer. ‘Application charges shall be collected at the time of submission of Appication form by the Consumer an shall be nonrefundable save ‘and except inthe event of non provision of PNG connection by MGL on account of technical non feasibility or nen provision of PNG ‘connection for any reason direct atvbutable to MGI. Consumption Deposit shall be collected from the Consumer atthe time of providing PNG connection or subsequently along withthe ‘month gas consumption bils as single payment n installments as may be decided by MG. USE OF GAS: ‘The Consumer shall () use the Gas specially for permitted domestic or household purpose only athe Premises and not for any other purposes. (i) make necessary appication along wih requisite charges as por the Prevaling Tarif Card and obtain speci prior writen permission Of the SELLER for change in use of the Gas at the Premises by instaling equipments such as geysers. (i) not e-supply the Gas fo any other Premises or permit any other Consumer to use the Gas without prior witen consent ofthe SELLER. PROCEDURES FOR GAS CONNECTION ‘On receipt of Appiation, the SELLER wil carry outa technical and safety survey ofthe Premises, ‘On completion of technical and safely survey at the Premises, the SELLER shall determine the locaton and manner of laying the pipeline and installation ofthe meter and other equipments for receiving the Gas. ‘On receipt of Security Deposit rom the Consumer, SELLER shal install the meter and other equipments atthe Consumers Premises for ‘suppivng Gas tothe Consumer ‘The instalation activity as above may be carried out by the SELLER himself or through its authorized representative as por the technical specications and safely standards inthe relevant regulations for technical spectfiations and safety standards. ‘The SELLER shal cary out necessary tests as may be required prior to commencement of Gas supply. ‘The SELLER reserva is ight to supply Gas to other Consumers through the same pipelines, at any time, up to the meter outey 'solation valve without effecting the Consumer's Gas suppy. CHARGES: ‘Consumer hereby confirms of having been fully explained by MGL regarding the tari charges payable by him to MGL for consumption ‘of Gas, cost of material and labour charges fr pipe and tubing, required tobe paid by him inthe event of excess utlizaton of the same ‘ver and above standard connection. (As specified in the Taf Card). Consumer further undertakes to pay necessary charges as statod ‘above or any ather charges and cost, if applicable, Consumer also agrees to pay separately for any aftersales service availed by him {28 per the prevaling rate ‘Tart Card will be provided to the Consumers along vith the Application form and the Consumer, on request, may also obtain the same ftom the SELLER, The rates spectied in the Tai Card will be applicable as of the date state therein. MGL may at its discretion revse/ ‘madly the charges from time to time, Consumer shall be required to quote the Consumer Relationship Number (CRN) as provided by MGL in all the correspondence with the SELLER. ‘The SELLER shall endeavor to provide Gas connection atthe earlestcorweniance date trom the receipt of Application; however, Seller shall not be responsible for any delay in providing Gas connection for the reason and cxcumstances beyond thet contol or for the wasons not directly atibutable to the SELLER, All cosses, tax, duties, assessments and any other levis imposed orto be imposed in future by any Government, Statutory andor local bodies in ralaton to the supply of Gas shall be passed on to and paid by the Consumer. BILLING AND PAYMENT: ‘Al Charges payable under these Terms and Condition shal be paid to MGL by way of Account Payee Cheque/DD/PO drawn in favour of *Mananagar Gas Lis" only. No cash payment shall be accepted unless specified by SELLER. MGL shall not be responsible for any payment made otherwise than by way of Account Payee Cheque drawn ints favour and such payment shall not give a valid discharge fo the Consumer. The Consumer shall enaure that payment is mado tothe authorized reprosentatve of MGL. However, MGL shall not be responsible for any payment made to any unauthorized person, ‘The quantty of Gas suppled to the Consumer shall be measured through a meter installed and maintained by MGL. inthe event of failure of the meter to record correct consumption, the quantiy shall be determined on the average consumption and in the ight of the ‘bumer installed by the Consumer. The decison ofthe MGL forthe quantity of Gas supplied atthe premises shal be final and binding ‘upon the Consumer. ——____ (Signature of the Applicant)63 65 36 67 68 69 610 an 70 30 aa 82 83 8s 86 e7 90 94 92 oa 94 100 t01 0 na MGL reserves the right to levy a minimum charge per month or pat thereof as stated in the Tarif Card towards, inter-alia, recovery of administrative costs (thal sto say, the Consumer vl be required to pay a minimum charge per month or the charges forthe Gas actually consumed, whichever is higher). The minimum charges payable are subject to revision by ML. from time to tim. Presently, MGL rales the bis on actual meter roading basis as well as assessed basis, once in two months. Thus moter reading is attempted once in four months and accordingly bls are raised. The peri ofthe fst bil may vary depending upon the date of the Gas supply and the classification of the Consumer in @ particular cycle. Assessments of the bils are carried cut based on the average: ‘consumption of the Consumer where history exists or based on the average consumption determined by the SELLER. The Consumer shall make regular payment of al the Gas bills including Assessed bis on or before the due dates prescribed in the bil ‘The SELLER reserves is right to vary the periodtrequency and manner of billing fom time to time without any prior notice to the Consumer. Ever bill shal be pai in Tull on or before its due date as mertioned on the bill by the Consumer faling which MGL shall have the right to clacannect the Gas supply of such Consumer. \yhout prejudioe o other rights ofthe SELLER, the Consumer shal also be lable to pay the delayed payment charges (DPC) as per the prevaling Tarif Car. In case of dishonour of any cheques for any charges payable to MGL. the Consumer shall, without prejudice tothe other rights of MGL here under or in aw, are liable to pay to MGL such charges as stated inthe Tait Card or as may be spectied by MGL from time to time, In the event of eisconnection or stoppage of Gas supply by the SELLER to the Consumer on account of defaultin payment or for any ‘other breach of terms and conditions, re-connecton of Gas supply shall be provided, only en submiting fresh application to MGL in accordance with Clause 12.0 In the event of non availabilty of meter acing of the Consumer during the meter reader's vist due to locked doors of Consumers promises o for any other reason, MGL may issue an assessed bil as stated above. In such cases, the Consumer shal be ile to make ‘the payment of assessed bil within the due dates and any adjustments thereto with regard to actual mater reacing will be carried out in ‘the subsequent bis. ‘Consumer is bound to make payment of Gas bl nfl on or before the due date even in the cases where the Consumer has lodged any complaint or raised any dispute with respect to Gas supply or otherwise. Incase of any dispute or any discrepancy with respect to Consumption /amount of bil, the Consumer is required to lodge his complaint within 14 days of making the payment and on receipt of Complaint, MGL wil ook into the issue and i found correct, will make necessary adjustments inthe subsequent bis. In no event, Consumer shall withnold bis raised on hiner. MGL will have the right of disconnection of Gas supply for failure to comply with provisions of tis clause by the Consumer, Ifthe cue date fr making payment of any charges or bili fang ether on Sunday ar any holiday, then the same shal be considered to be due on the nextday ofthe holiday. ACKNOWLEDGEMENT / RECEIPT : Duo acknawiedgement/ receipt of al payments made by tne Consumer are provided by MGL or Is authorized representatives. The Consumers are require to ensure to obtain necessary acknowledgement /recept in respect of each payment made in favour of MGL. ‘OBLIGATIONS OF THE CUSTOMER ‘The Customer shal rir to the commencement of Gas supply, at his own cost, be responsible for obtaining all necessary consents, approvals and permis ather than statutory authorities, as may be required, to obtain Gas connection. The Customer shall a his own cost, ‘also be responsible for obtaining all easements or rghts of way through any private propery af any other person fr laying of pipeline for supply of Gas, ‘The Customer shall permit the SELLER, its authorized representative access to the Premises for the purpose of laying pipelines and ‘making instalation and als t afer or replace any pipeline, installation ar equipment the SELLER in is disereton determines the same to be necessary or expedient “The Customer shall obtain no-objcton certificate from the housing society andjor the landlord (in case ofleasad promises) and provide to NGL for Gas supply at the Promises. I any dispe arises between the Consumer and the landora/eociely the SELLER reserves Is right to discontinue the Gas supply frthwh, ‘The Consumer shall ake all adequate precautions and adopt all safety measures to safeguard pipeline, meter and other equipments Installed by ML at the Consumer's Premises fr supply of Gas. Incase, Consumer carries any unauthorized repair, ateation, modification rectly or indirect inte pipeline, meter, equipments installed forthe purpose of Gas supply the same shall be deemed tobe breach of the contractual tems contained herein and in such cases MGL shall have ful right to frfelt the Security Deposit and disconnect the Gas ‘supply tothe Consumer. Further, incase of any accidanl incident, on account of unauthorized repair, modification, alteration drecty or Indirectly to the sipetine, Meter equipments, the Consumer shall be soley responsible for any loss or damage that may be caused tothe property of human life, MGL shall nat be responsibie for any director indirect loss caused on account of any such ilegal act by the Consumer. Consumer shal notify MGL incase of non receipt of () frst Gas bill within the period of two month trom the dato of Gas supply: (i) periodic Gas bis within 10 days trom the expiry of two months period of receipt of the previous il. Incase of non receipt of the Gas bil, the Consumer shall obtain duplicate copy of the Gas bill and make the payment ofthe same within the due date ‘On noticing any burn or damage to the meter or nonfunctioning ofthe meter or damage to any of the equipment in the premises, the ‘Consumer shall intimate the same to the SELLER and SELLER shall replace or rectly the same at the earliest available opportuni Consumer shall be responsible for any civil work required for he safety of pipelines, piping or other facies and equipments installed ‘by MGL within customer’ premises. PRQPERTY/OWNERSHIP “The pipes, equipment and other installations provided fr the purpose of supplying Gas up to and including suraksha hose pipe connecting the Oummer shal be anc remain the property of the SELLER and the Consumer shall nat have or claim any ight, ile or intorest therein, ‘The Consumer shall ernit the authorized representative of MGLto enter upon the Premises for the purpose of mater reading, inspection land maintenance checkups. The Consumer shall vey the identficaton of such authorized representatives prior to permiting such persons access upon the Premises. The SELLER shall not be lable /responsile forthe entry by any unidentified person or any imposter ‘or person cling to represent or act on behalf of ML “The Consumer shall no tamper of interfere nor permit any tampering or interference with the pipes, equlpment and other installations provided fr the purpose of supplying Gas. MGI shal, without prejudice to its other rights, be entite to disconnect the PNG connection ‘without giving any prior notice and shall be ened to recover suitable compensation for any damage caused to the equipments by the Consumer apart fom fring the Securty Depost. ‘The Consumer shail not adjust, clean, repair, replace or otherwise hancle any ofthe pipes, installations and other equipments. The Consumer shal immediately intmate to the SELLER, If any damage or breakage ofthe pipes, Insalatin, and equipments is noticed at the Consumer's Premises, WARRANTY OF SELLER ‘The SELLER shall endeavor and take all reasonable steps to provide the Consumer with consistent and regular supply of Gas. TERMINATION Without peejusice to other rights of the SELLER inlaw or otherwise, the SELLER may at any time and with prior notice terminate the Gas supply ofthe Consumer i (Consumer fais to pay the SELLER any sum due tothe SELLER under these Terms and Conditions anor otherwise within 30 days ‘tom the due date for payment thereof; or {The consume fais to comply with any of ts obligations andor commits any breach ofthe covenants or conditions on his part be ‘observed, performed 0 fufiled or {l)._The Consumer dis and the successors and assigns do not submit tothe SELLER the necessary documents within such reasonable ‘ime as required by the SELLER trom the happening of such an event or becomes insane or insolvent; or (@) Tho particulars as furnishod by the Consumer in the Application are found tobe fa ‘or incorrect: oF —_—_——_— ‘(Gignature of the Applicant)