Sr. No.

Hend Charges for loadup to 25KW

Processing Fees
100 4

Fixed Charges 2036 54a (without meter)

Meter cost
15000 5 4
3
3084 59Y
4 GST 18 %
202205yy
Total One Time Connection Charges
500 t9Y
First Prepaid Racharge
20720 5Yy
Total

UHTT fHTT ERT Eà uTA aId f

3GTERT-5 fOTO HH yY Ai 600 RWA

4399.00 ETtt, frrd Fye Fu 5 foaTO FYT UY HTRTC5 600 tE 4HT UY TTHT 16% I 5TTET

Considering a 5 KW connection with 600 unit consumption

Single Point/Bulk Connection Multipoint Individual Connection
5 KW 550.00 Fixed Charges@110/KW 5 KW 550.00
Fixed Charges @110/KW
Energy 600 KWH
Upto 150 KWH@Rs. 150 KWH 825.00
5.50/kwh/month
From 151 to 300 KWH@Rs.
.150 KWH 900.00
6.00/kwh/month
600 KWH
Energy Charges@7/KWH 4,200.00 From 301 to 500 KWH@Rs.
200 KWH 1,300.00
6.50/kwh/month
Above 500 KWH @ Rs.
100 KWH 700.00
7.00/kwh/month
Total Energy Charges 3,725.00D
Electricity Duty @5% 237.50 Rebate(Prepaid Meter) Q2% 85.50
Additional charge@ 5% 227.50 Electricity Duty @5%_ 209.48
Total Bill 5225.00Total Bill 4398.98
Payable Amount 5,225.00 Payable Amount 4,399.00
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4
 This form is available
(TE 3TEA AT TYE
free of cost
PASCHIMANCHAL VIDYUT VITRAN NIGAM LTD.
Eiectricity Urban Distribution Division...., Sector. NODA
Annexure-4.1 (Ref. Clause 4.4)
fpekapy folqr forj.k fuxe fyeVsM
Application Form For Requisition Of Supply Of Energy

Affix latest Photograph

1 Name of the of the application
Applicant (Attested by Gazetted
3HTCE *********************************sessteses***nssdoss**sionesse*ssssssssesn***a**etna*********** Officer/Bank
2 Father/Husband's Name Ofiicer/Gram
Pradhan/Sabhasad)
*********************************************t***t*oss*t********ssrsesnaes*********

3 Occupation
***************************************************************"******************"***** *************"*

4 Address, Where Connection is Required (T, TEÍ DPTA TAT 3)

******"***********************************************************dtun***** s ****i** ssesessso**********************************""****

**************"******************************************* ***********************************************************************"******""***

****"********************************************************************************************************************************************************
(a) Address of the Applicant (3TOG5 UTM)
*********"**********************"************************* ****se ***9*po*s**s*pesousee******a*p*s***o*************************************s********************"***"**

M o b i l e No. . . ****s*nretnso*************************************

Phone No (HT O)..*************************************e*** ******

**************************************************

yD/EHuA/f¢aNT I E)*
(6) Building is Single story/Multi Story/Developed Colony(a ************neoopesse. O feet (T E)
5 Plot Size (Taus I GTCPIK). Sq. feet (t ge) Covered Area (1TÈT )
**********************s*s

*****************************s******************************************a*************************************************************
6 Total Connected load ( TGTT TR)
7 Purpose of Supply ( T TET).
**********************************************************************************e* ******************************************

**************************************************************************************************************************

8 Processing Fee (y5H T . **************

Enclosures
1. Work Completion Certificate and
Test Report (B&L form)

If the applicant is not the owner of the

of lawful occupation of the premises.
2 Documentary evidences in support Licencee shall be enclosed.
as specified by the
premises, indemnity bond

of the
Factory/Industry/Premises/EstablishmentlHouse map, Where supply is desired, indicating tentative position
3.
meter box.

4 Receipt for payment, if cash/draft

Note e without MDI meter, the

connected load can be 200% of
the contracted load in the domestic
1. In case of consumers
the commercial category.
category and 133% of the contracted load in

uHHd 133 HtAATT EI FTTT) and obtain

"
No Dues Certificate"
of your electric supply,
ensure permanent disconnection
2. In your own interest, please the premises.
from Division before vacating
of the premises.
Electric Connection shall
not be treated as a proof of ownership

then is it electrified by developer Yes/No

Building is Multi Story/ in Developed Colony

Applicant's Signature