TENAGA NASIONAL srrHap (eo0es6.n) UUNTUK KEGUNAAN PEJABATIFOR OFFICE USE Nesonbooe (TTT TT IIIT sesiner (TTL TT Ce em Ores Rs eateeieey 1A. BUTIR PEMOHON/APPLICANT'S DETAIL GelsanSakiston (ErokPuantCiCesrantah_____)wiokPLamaowiena § COCCI tuna eStit) vormanuniwions CECECEEECELILD aa Nora Fonte veresarssane. CEDEELEELELEEL «© 18. ALAMATIADDRESS Bi chantetets sontto—[] Aart PromiaPenive Ase ‘Atat Panis Bag Pemaonan Belin Eiri Aass tormatenspaaina Pniean CELLET (Co. Registration NoJBushse Rogista6on No. Anat serena ass eral Sater Atte ia Teatat(T] ‘No. LoUNo. Pangsapur / AlamatlAddress feet Bangunan [ LI Lit LT OI TTTT LITT eae paieersatras COCO) ot OT COCECCCECECEEEEC eee) ee Twrevsercyen [TTT TTT TTT ITITrri tty Bender CT TTT TTT TT TITTIITTtr coacmeae ri roses TTI eget COO) Poe a sone CETL TCT won COO i peonsnen Negeri [TT TTTTTTT 1h) een’ CO TTTTTTTTT cue anes weeny COO) rw = COO rope 9 ate wine COTE TO eww COO Telephone (0) emt PEEL) ‘wen oot CLIT TT sore reveiooe COO eo COCDEEE EEE errr) fo fia PoctantsSute Dl eenttion — C] sovarnen — [L] taniaoner ‘+ Borang prmetoran ir bolh dmgukan ke Kd Tenaga yang barhampan dengan promis ands/ The azpcton frm may be submited fo the Kede! Tenge nearest toyourprenise += Borang pemohonan in cber secre porcumaThiegppaton form fe dstbued foe of charge * Borang pemahoran int hendelish dsl denger pena mala tsa/Tls aplication for iso be filed wt bal pit pen1C. MAKLUMAT PENGARAHIKELUARGA ATAU SAUDARA TERDEKAT/ DIRECTOR'S INFORMATION/FAMILY OR RELATED PERSON 3 Nama Name Wo. KP VION Tio Telefon Telophene Na. | _Almat Roneh | Home adios 41D, JENIS PERMOHONAN/TYPE OF APPLICATION “sia tansekan () pata pihaniPease sec (9 [0]. betalan Boar ar TetapyNow Bec Supely [Fo] stlan eon tarbananAcsttons Eectty Sumo a Oo Bekalan kirk Sementaa Temporary SuppWy Penskaran PenggunaPenstarn Tac Bahan 2 bik pra dis) (Change of Tenaney/Change OF Tart (Donat it Secton 2) 416. JENIS PERNIAGAANITYPE OF BUSINESS “Sia tndakan () pa pthan/Pease sec Ly Porendianso Roptastlp [E). PenengsianPanesn E senatian snasirste Lmtd a ad Oo ‘xiv PemiagaariBusness Actity 4F, TARIKH BEKALANISUPPLY DATE “Tah Bekaian Dpztuker Date Supoly Recuired va 4G. PERAKUAN PEMOHONIAPPLICANT DECLARATION Dongen 1 Seyermemperséalbahawa konkaloe yang saya lank alu yang cnt cle Pema yong namakan di belokang In dais kortaitor yang berdsfiar dengan Surunajaya Tenaga, Saya Joga member kebenaran tepada Kortralearunuk menguruskan kerja berkattan dengan permohonan sain Soya beset dengen semua oyerat balan Elk TNB soport i alam Syart-Syoral Botton bog! pongcuns Pemiagean J ‘Bukan Demnsti ‘Saja beret membayermenyolesskan semua bayeransambungan bekalan ita berkaten) dan semua wang cagaransabelum bet ‘dveran ‘Seya berets membanty TNB untuk mendapatkebivsanteenpunye tanlvpremis bag] menyardbung Beka Ke pes tersebut. ‘Se toda halagan bagi TN mengguakan usn sesolur kaki i reris soya Saya mangisshkan makiumat yang sayeberkan tas astsh bona san TNB bernak mengamtil apa-pa dadekan yang sewejemya ka maka yang eben ash dapat dak bone. Rinna Puanalnns Of Aipiiend ECC Cee ere eee cee Setom Kasi randstangenSh fius0.00 Tandstangon/Signatre ‘Stamp Duty ean tn Tarltvoate ScesSESSEETSS ‘Sanat cee BeshadlPubti ited Kerajaan/Goversmont Laisgivownere o/CO/O10 bbimm— ay Woody: 4.1 Hereby atest that the contractor appontd by mehousing developer ‘8s named neren fa contractor registred wth Energy Commission 89 ‘give pormsson ft contractor odo al necessary Wor elated 0 my ‘npioasor 2. Ivey agree fo be Bound by af forme snd canons eating to oars supply of TN asin Corin OF Supply For Business ‘Non-Demeste Consumers. 3. herby agree to payfete af connection chrge (ary) and deposi ror othe elocticly euply. 4 thereby gros fo asst TMB io obtain the nda’ pomieson fo cannest the supply othe sald preise. 65. Ihave no objects for TNE o utes he fvetoot mans in my premise 6. herby sckronlege tha al formation given are tu and TNB shat have te right ate any aetion Ie oration given ae fale. Pavano Siren2A, BEKALAN ELEKTRIK TERDEKAT/NEAREST ELECTRICITY SUPPLY "No. Akaun Plaga TerdlaNooret Customer Aecourt No 2B. KAEDAH BEKALAN/TYPE OF SUPPLY “Sila tandaken (/VPlease tick (/) No Tang Eek Tedekaueares Eletica Pole No 20. BUTIRAN BEBAN / LOAD DETAIL [1] sau raslsnge Phase [) crWet sister se CCadangan TatPrpsod Tait Tite aban? toad Datal “Tani Baba Sambungan (1 Total Load connect Tanendai Makeina (9) Mexinum amend dang Baten Sedade/ Existing tos Beton ‘ambanan/ Acttona! Load eben Baro? New Load Aah Beban 7 Teteltood ‘acongan tan Proposed ™ otage 2D. SILA TANDAKAN (/) PADA SALINAN YANG DIMAJUKANIPLEASE TICK (/) COPY OF DOCUMENT PROVIDED Kad Pengonalan Pomehen/Apolean’seriy Card FRajoh SkomatikPemasangar/Schamatidlagram Leven Penglang Pemoton(sektaryaberktan “Applicant's Fectoy Lance i Appeabie) Borang @ &H (step pepassngsn ssp epssang don i)! 84 H form (ater wing Is completed and tested) ‘Salen Borang 48/C09y Form 49 OO 0 000 ‘Sinan Si Pendataran SyantaPeriageen/ {Copy of Registain Of Compeny (ROGHBusiness (ROB) [Leon teperchsiste Pantocaon ‘+ bogie tara ca 100k, pean tapak¢ {orice oss than 100, please ithe sta plan, + bagibeban bin dar 100K, tampitkan pot apakarparna jah ‘kemat pomasangen dan tandatangan seta cop porunding lek yong sah! {or oad over T00KVa, please atach deleted plan, schamate dtagram ‘nd skgraure and coneutn! engineers oe sar.PELAN TAPAKISITE PLAN PETANDA LESENDS ‘Nena Syarkat Gop, Marat IB Pons par bokatan IE Proms that roqute supely No.7 Ne Sf Perataran SBEGST © Thang Seiade Existng Poe : aden egyoan Popes dee aeareeeysare ssa tae, ant baton Quentiy pole CCedangan aan, yaaa Proposodte, lease seat Bevan ena, meter ‘Unsergeuns ‘motor Lily Talanatee meter t+ Ovemeadtine ‘metor Tlan Secasde Exiting fe 4 Potok pen cara 4 Toes tobe ct down ¥ Dahan pe deatss ¥ Branches for cearance “+ Puncabekain > Source of Supiy — = Cadogan seri, — .—. Proposed sonic, ‘yataian meter Soeaty meter Tina SCONES ATES vent [Ses [Seas ‘sez [Sesags (ca Sarbungan (RM) [eens epost Tee sonata [Baw a ouoene [2 RoLKICKBM, CGewrontoo | TnbSRaR Ne Kerrie kena Tarik Bekstan DiborikarVTarkh Kontak / Co’oW ooo Date of Suppiy/Contrect Date Alomat ElettkiBlectrcal Address No Perkakas ‘SuieLink No Disemak Kerani Keunter: Nama Pekerla No, Pekerja Tandatangan ark Rivas bimm = ttyryy gom ‘CoD ‘No Peli Pembekal ! FPNe No Papan Agihien Voltan Rendah / LvD8 No Dituluskan Oleh: Pegawel Yeng Dikuasakan No, Pekerla ‘Tandatengen Tack Dikeluarkan olah Jabatan Perkhidmatan Pengguna & Pemresaren, Bzhagian Pembahagion, TB 1. 24 hours TNB Hotline - 15454 2. Electricity Bill Payment Channel: ‘Direct Debit - Credit Card # Direct Debit - Savings / Current AIC ‘¢ Bulk Payment System Kedai Tenaga ‘© Auto Teller Machine (ATM) 3, For further information please refer to TNB website at http:iwww.tnb.com.mny '* Websites (TNB, Banks & Collecting Agencies) ‘= Phone Banking ‘© Over The Counter (participating banks) '* One Stop Collection Centres