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1 ection. Applicant etails (ill as applicable) a. Name of Applicant (specify as mentioned in proof of photo identity applicable for individual) / Organization Name (applicable for Organisation) b. Additional etails (Applicable for ndividual ) R r. itle ale/emale c. rs. s. Others E A Others (Please pecify) ate of Birth ather's/husband's Name r. R E A other's aiden Name rs. R E A E A Additional etails (Applicable for Organisation) Name of Authorized ignatory R esignation of ignatory ate of ncorporation ype of Organization (Refer ection c of New Connection Application anual) ection 2. 2a Address Communication Address (applicable for ndividual) and Registered Address (applicable for Organisation) / Billing / andlord Address House No. Building Name treet Area andmark obile andline Please provide your contact details to help us serve you better 2b. Premises Address at which Connection is required House No. Building Name treet Area andmark obile ection 3. Category 3a. ate ignature of Applicant/Authorized ignatory

2 3b. 3c. ype of Area Jhuggi Jhopri Cluster Others (Please pecify)... ype of Premises Company Provided Rented/ease Owned Govt. Provided Others ection 4. 4a and Purpose/usage of new connection - Refer to ection 4 of Application anual and mention relevant here ention escription of purpose/usage as mentioned in ection 4 of Application anual here eter Choice 4b Applicant's eter Voltage evel 4c Phase 4d 4e ection 5. ist of documents attached if applicable ate ocuments Received : ignature of Applicant/Authorized ignatory Acknowledgment Request No. Ownership Proof: Address Proof: Others: Name esignation

3 eclaration son/daughter of resident of (hereinafter referred to as 'Applicant' which term shall mean and include executors, administrators, heirs, successors and assign) do hereby swear and declare as under Or Or Or a. ndustrial b. Agricultural Consumers c. Non-omectic for Khokhas and emporary tructure 8. he above referred applicable documents indicated at various points are available with me and can be inspected by the icensee at any time. n case of any failure to produce the same, the licensee may disconnect the connection granted owing to such failure, reluctance on my part to produce/allow the inspection of said documents.

4 As per ERC supply code 207, Earth eakages Protective evice(ecb) installation is mandatory for all type of Electricity connections and applicant has installed the ECB in accordance with the regulation. ate

5 (Not to be submitted with Application. o be retained by Applicant) ntroduction non - Govt. applicant. part of your application.. New Connection Application cum nformation orm for Permanent Connection along with self-attested passport size colour photograph of the applicant / authorized signatory (applicable in case of organisation) pasted on the form 2. eclaration upporting documents to be submitted by the Applicant (for all applications) :. Copy of Proof of dentity of the applicant in whose name the connection is applied for 2. Authorization in favour of signatory (applicable in case of organization) 3. Copy of Proof of lawful ownership/occupancy of the premises for which the connection is applied for, in the name of the Applicant. 4. Copy of proof of photo identity of the authorized signatory (applicable in case of organisation) General nstructions : are free of cost. n case where a copy of certain document has to be submitted, the Applicant needs to produce the original documents for representative at the time of submission; the original documents must be retained by the Applicant. must be self-attested by the Applicant. he Applicant s photograph should be self-attested. representatives visiting his premises. All payments should be made only against computerized emand Note(s), and receipt thereof must be obtained and kept safely by the applicant. n case of any complaints of harassment or corruption, please report on Helpline No. : Payment Counters. Please note that Payments of amount of Rs. 4000/- & above should be made by way of../pay amuna Power imited. ection : Applicant etails a. Please specify applicant name as in the proof of identity of the applicant / organization. b. P c Company registered under the ndian Companies Act 956 ociety registered under ocieties Registration Act 860 rust whose trust deed is executed under the ndian rusts Act 882 Partnership whose partnership deed is executed under the ndian Partnership Act 932 Proprietorship Name of Authorized ignatory: Please specify applicant name of authorized signatory as it appears in the proof of identity Charges payable for New Connection he charges payable by you to (i) Advance Consumption eposit/ ecurity eposit depending on your anctioned load and tarif able below: able. No. Category omestic (i) Upto 2kW (ii) Above 2kW upto 5kW 600 (iii) Above 5kW Non-omestic ndustrial Agriculture Public ighting Railway, RC, A, JB ushroom Cultivation Advertisement and Hoardings assessed for a period of twice of the days applied for temporary connection or a period of two months whichever is lower ource: able 2, elhi Electricity upply and Performance tandards Regulations 207

6 (ii) ource: able 4, elhi Electricity upply and Performance tandards Regulations 207 ection 4 : General Particulars 4a: etails about purpose / use of electricity for which the connection is applied for Please refer to the table below and depending on the purpose / use, for which a new connection is required, specify the. omestic. omestic/residential lighting ndustrial (except Household ndustry) ndustry in conforming 3. ube well for irrigation (except for activities listed in 4.8 of this 3.2 hreshing and kutticutting in conjunction with pumping load for irrigation purposes ighting in kothara areas.2 Common meter - compound lighting/portico/staircase.3.4 equipment in residential complexes Co-operative group housing omestic farmhouse - available for loads.5 domestic self use and bounded farm houses having minimum 50% of the total land for agriculture/ vegetable cultivation Professionals like ndustry in nonconforming area/urban area ndustry in rural area ushroom cultivation with an area upto a maximum of 50% of the area cover for carrying out professional work.6 employed 2. 2 employed 3. 3 employed Non-omestic 4.2 Khokas/kiosks/temporary structures such as pan shops Hotels/restaurants/ice-cream parlours/eateries/inns/ Guest houses Auditoriums/cinema/libraries Petrol pumps armhouses used for commercial activities such as marriage/parties etc nursery Hostels/schools/colleges/Hospitals, nursing homes/diagnostic centres (other Household ndustry Any other purpose/use not indicated in any list Places of worship - temple/mosque/gurudwara/ Church ispensary/hospitals/public libraries/working women's for providing charitable service only Recognized centres for welfare of blind, deaf and dumb, spastic children, physically handicapped persons as Chesire homes/orphanage Electric crematorium

7 Consumer Copy rom: / s. (Wiring Contractor) Req. No. ear ir, We hereby inform that Electrical inspection at the premises bearing No. / situated on Road / treet (as per address given below) occupied by (as per Applicant's name and signature as given below) has been completed by us and is ready for your engineer to test and connect up with your mains. he installation was tested by us on date.. and the installation resistance was mega ohms. he inspection comprises the following: No. of circuits left to right on istribution ize of Conductor amps No ans No Plugs (5 Amp) No Plugs (5 Amp) No Other omestic appliances escription Circuit No. Circuit No. 2 Circuit No. 3 Circuit No. 4 Circuit No. 5 Circuit No. 6 icensed wiring Contractor (Name) icense No. ate Address City Name of the Applicant /o. Address where supply is required City Address where bill is to be sent City ignature of Applicant ignature of Wiring Contractor ate : (b) for low voltage installations of 2 kw and above is mandatory. * We are following CEA regulation 200 (easures relating to afety & Electric upply).

8 No Objection from andlord / Co-Owner (in case andlord is individual) son/daughter/wife of aged (years) resident of (permanent address in case landlord is an individual/registered Address in case landlord is an organization) do hereby declare that :. /We own the premises/building bearing municipal no. and address : (hereinafter referred to as the premises ). n case andlord is an Organization,, the undersigned, declare that am an authorized signatory, empowered to sign. signatory). 2. hat /we have rented my premises to : (full name of tenant, hereinafter referred to as the enant ). 3. hat /we have no objection if the tenant applies for a new electricity connection on the said premises, and the same is right to disconnect electricity supply of the said electricity connection, as may have been provided against the application for new connection submitted by the tenant at the said premises. ignature of andlord andlord s ull Name: Ref. No. his is to certify that:. have personally inspected the building bearing municipal number and address as. 2. he said building has been constructed as per the applicable building Bye-laws duly sanctioned by the competent authority. hitect Architect s Name : Architect s Registration Number : ate Place