APPLICATION FOR CHANGE OF NAME

FORM 'X'

Consent for change of Name / Ownership of Installation

1. Full Name, address and profession / Occupation of

transferor.

2. Full Name, address and profession / Occupation of transferee.

3. Full Address of premises served by transferor.

4. Electric load involved in kW / HP

Meter No.

5. Nature of factory / establishment

with products / Nature.

6. Is the transfer of business through a registered

deed or documents, if not, how is it being

effected.

7. Consent of the transferor to transfer the

connection.

8. Consent of the transferor to transfer security

deposit.

I Shri / Smt. / M/s. ___________________________________, hereby give consent to transfer

the connection and security deposit in the name of transferee Shri / Smt. / M/s._____________

__________________________________.

Signature of Transferor Signature of Transferee

(Old Consumer) (New Consumer)