APPLICATION FOR TRANSFER OF SERVICE CONNECTION

I hereby agree to transfer Service No. ___________Cat ___at Loc

No.__________of_______________Section______--_________Town/Distribution to
Sri.________________________S/o____________________withSecurity Deposit pledged by
as I have________________________Full Name____________________S/o
______________________________

Signature of Transferer

I Sri__________________________S/o ____________________here by agree

to make transfer of Service No. ____________Cat_____Section
______________Town/Distribution standing in the name of Sri
________________________S/o.___________________ H.No._________with Security Deposit
as I have ____________________________________________________________.

The premises of Sri ____________________________ I here by agree to

abide by the conditions of the department made by the NORTHERN POWER
DISTRIBUTION COMPANY TELANAGANA LIMITED (Requisition entered by Sri
_________________________________________________
with the Department.

I agree to execute agreement (Requisitions) and conditions

prescribed by the Department if required.

Full Name: Signature of Transferee

Father’s Name:

Address:

CERTIFICATE

1. Certified that the Transferee and Transferee signed in my presence.

2. Certified that the transfer does not involve any shifting of meter board
from one place to another place.
3. Certified that the Trarnsfer is genuine.

Place:

Date :

Endt. No. EI/CSC/ /F.9./D.No. _______________/ Dt:__- -201

Copy Submitted to the ADE /___ /_________________ for necessary action please.