1.TAKE PRINT OUT OF THE GENERATED APPLICATION FORM.

2.SIGN AT THE SPACE PROVIDED FOR APPLICANT’S SIGNATURE.

3.ATTACH A LATEST PHOTO & SIGN ACROSS PHOTO.
4.SCAN THE SIGNED FORM AND UPLOAD.

Online Application Form For NAME CHANGE

REQUEST TYPE NAME CHANGE

APPLICATION REQUEST NO 26181

Latest Photo
SERVICE NO 500280654 Please Sign Across
Photo
TYPE OF PREMISE LT:RESIDENTIAL

NAME OF REGISTERED CONSUMER MANSUKH KANJIBHAI MAKWANA

NAME OF APPLICANT Mr. KALUBHAI P CHAUHAN

LEGAL STATUS OF APPLICANT OWNER TOTAL LOAD(KW) 0.960

ADDRESS : CORRESPONDENCE ADDRESS :

PLOT 160 MADHUVAN CO-OP. H. SOC PLOT 160 MADHUVAN CO-OP. H. SOC
B/H BHAGIRATH NAGAR B/H BHAGIRATH NAGAR
VARACHHA ROAD VARACHHA ROAD
SURAT SURAT
B/H BHAGIRATH NAGAR B/H BHAGIRATH NAGAR,
395006 395006,

MOBILE NO 7434053717

EMAIL dkc0035@gmail.com

To,
Torrent Power Limited
I/We hereby request for New Connection/ Reconnection/ Load Alteration in Existing Connection to supply electrical energy at Low
Voltage for the premises owned/ occupied by me/ us.

Declaration
I/We hereby declare that [a] The information provided in this application is true to my knowledge [b] I/We desire and agree with the
distribution licensee to avail power supply for the above mentioned purpose and of the load shown in this application form for the
period not less than two years from the first day of the month next to date of commencement of power supply by the licensee. [c]
I/We have read the Supply Code issued by GERC and agree to abide by the condition mentioned therein. [d] I/We will deposit
electricity dues regularly as per the applicable electricity tariff and other charges. [e] I/We will own the responsibility of security and
safety to the meter cut-out and the installation thereafter.
I/We, understand that as per the order dated 20.12.2018 of the Hon’ble Gujarat High Court, Torrent Power Limited has not charged
and collected Goods & Service Tax against my application.
I/We hereby unconditionally undertake to pay M/S. Torrent Power Limited, the amount of Goods and Service Tax (GST) along with
interest as applicable, if the same is demanded or made payable by law in future for any good &/or service billed by Torrent Power
Limited.

SIGNATURE OF APPLICANT WITH DATE (If signing on behalf of a institution or company please affix the company
stamp)
IMPORTANT POINTS

1) Please ensure all relevant details are filled clearly and are complete is all respects.
2) In case of application of transfer of name, the applicant shall comply with relevant regulations.
3) In case of application for transfer of name the lieu of deceased person is required to submit the death certificate as well as
succession certificate.
4) If the occupier is unable to obtain no objection certificate from the owner of the premises, they may visit company's officer
personally.

REQUEST YOU TO READ THE DOCUMENT CAREFULLY AND SIGN WHENEVER APPLICABLE.

UNDERTAKING

I/We take the responsibility that the document submitted along with proofs for the name change process is the latest proofs and
there is no change in the ownership of the property after the date mentioned. The documents submitted are authentic and reflects
ownership/ legal occupancy of the premise. I/We will be held responsible for any legal objection from past owner or any other
person and it will be my/our part of duty to resolve the objection at my/our cost and risk also and shall indemnify company against
any such losses the company suffers and assign the right to revert back the name to previous owner. I assure that there is no legal
order or pending legal cases on the ownership of this premise. I adhere by the company’s rules and regulations and abide by the
provisions of Supply code. I /We are liable to pay any type of outstanding dues against the service, any type of differential security
deposit and any dues left from the previous owner of the service.

NEW CUSTOMER’S SIGNATURE____________________

NO OBJECTION CERTIFICATE

I the undersigned declare that according to company records the premise with current service no 500280654 is sold/ rented for
residential/commercial activity in accordance to sale deed, sale documents, live and license agreement and I have no objection to
change the name of the service owner to the applicant’s name. I also agree to the company rule that any security deposit amount
in the service no account or the paid differential security deposit will be transferred to new name customer’s account.

EXISTING (OLD) CUSTOMER’S SIGNATURE__________________

 JOINT OWNERSHIP APPROVAL

Respected Sir/Madam

SUBJECT-Name change for Service No 500280654

The above stated electricity connection, having service no 500280654 is attached to jointly owned property of the undersigned
owners. We have no objection if the above mentioned service connection is being transferred to the name of Shri/Smt
KALUBHAI P CHAUHAN

Joint Owners Name SIGN