Ref.

:- ____________
Date:- _____________
To,
---------------------------------------------
---------------------------------------------
------------------------------------------- (C.G.)

Sub:- Regarding fixing of monthly refill quota for our exempted connection cons. No. ----------through.
Your Distributorship M/s---------------------------------------------------location -------------------Dist.
----------------------Sap Code-------------
Dear Sir,
With reference to the above subject this is to inform you that we are having one exempted
category connection from your distributorship with following details:-
1. Cons. No.-------------------
2. SV No. & Date-----------------------
3. Purpose------------------------
4. No. of persons for which food is prepared-----------------
5. No. of times food is prepared--------------------------
6. No. of cylinders loaned ---------------------------
7. No. of PRs loaned-----------------------------------
8. No. of refills required per month (Monthly Quota) -------------------------
9. Mobile No.----------------------------
10. Mode of payment for refills---------------------------
We shall be making payment for refills supplies only through electronic mode, Cheque (Customer’s
account only). We hereby also confirm that the above information is correct to best of my
Knowledge & refills provided under above connection shall be used for our own consumption and the
purpose mentioned above.

Thanking you,
Your faithfully

Name & designation of Authorised Signatory with Seal