Temp Application
Temp Application
To,
The Manager
Hajo Electrical Sub-Division
APDCL (LAR), Hajo
Sir,
I / We, request you to supply electricity to my / our premises. The requisite information is furnished below:
1. Name of Applicant (IN BLOCK LETTERS) : M/S. RELIANCE JIO INFOCOMM LIMITED
2. Individual / Govt. Deptt. / Other Organisation : Telecommunication Service provider
3. (a) Name of father / husband (in case of individual) : N.A.
(b) Name of Department / Organisation :
(With Designation of Applicant if applicable)
4. (a) Full Address for correspondence and sending bills :
Bijay Crescent Building, 2nd Floor, Rukmini gaon, Six Mile, Dist:-Kamrup (M), State: Assam
PIN-781 022
(b) Address of the premises where the temporary connection is required:
House No. / Plot No. :
Road :
Lane :
Area / Colony : Vill. -Ujankari, P.O. -Ujankari, P.S.-Hajo
Town :
District : Kamrup
PIN : 781102 Telephone: E-Mail:
(c) If in the same premises, the applicant already has a service connection? Yes or No
If ‘Yes’ attached the latest Bill(s) duly paid
7. Connected Load:
Sl. No. Fitting/appliances Rating (watts) No.s Total Watt (kW)
1. Tube Light 50 6 300
2. Bulb 60 2 120
I / We have read the AERC Electricity Supply Code, 2017 and agree to abide by the conditions mentioned
therein, particularly those related to ‘Temporary Power Supply’ as incorporated under clause 4.5.2.
I / We agree to deposit an amount as security deposit for load and also for meter (If applicable) before the
connection is provided to me / us and also additional amounts as may be due from me / us, against
demand raised by the Licensee at the end of specified time period for which connection is required.
I / We will deposit electricity dues, as and when Bills are served by the Licensee, as per the applicable
electricity tariff and other charges.
I / We will own the responsibility of security and safety of the meter, cut-out and the installation thereafter.
Name:
Date:
Place: