Annex.

CMG-02

Legal Heirs Certificate cum NoC

(On Rs. 10/- E- stamp paper with Notary Stamp)

Tata Power-DDL New Connection / Attribute Change Notification. No.is _________________

I/We declare that Mr. / Ms. ___________________S/o/, D/o, W/o Mr. / Ms. __________________
expired on _______________ (Copy of Death Certificate Attached), who was the owner of the
property having address___________________________ , leaving behind the following Legal heirs :-

S. No. Name Address , Relation, Age

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Now, one of the legal heirs, Mr. /Ms. ___________________S/o, D/o, w/o _____________________
has applied for a new electricity connection/name change against CA NO.______________________.

I/We have no objection if the New Electricity Connection/Name change will be sanctioned / effected
by the Tata Power-DDL in the name of Mr. / Ms. _________________.

I/We also authorize Tata Power-DDL to transfer / adjust the security amount in the name of
applicant.

I / We solemnly affirm that the information furnished above is true and correct in all respects. I / We
have not concealed any information. I / We also understand that Tata Power-DDL has every right for
name change reversal / disconnect the supply without any notice on account of any details /
documents provided proves to be false / incorrect at any stage.

It is my / our true statement.

Signature of Deponent
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Verification:-
Verified at Delhi on _________ that the contents of the above affidavit are true and correct to the
best of our knowledge and belief and nothing material has been concealed or suppressed.
Signature of Deponent
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