Government of Jammu & Kashmir
Power Development Department
Application form – New Connection (Low Tension Service)
To ___________________________
(Representative of Licensee)
1 Name of the Applicant/Organization:
2 Name of father/husband/Director/Partner/Trustee:
3 Address:
(a) For communication House/Plot/Premise no.
Street
Area/Colony
District
Telephone No.:
(b) Where the new connection is applied for / existing House/Plot/Premise no.
connection is required to be shifted
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Street
Area/Colony
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District
(Indicate landmarks to identify the location)
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4 Plot size: ……………………sq. feet Covered area: ……………………sq. feet
5 Category of Supply: (list of categories attached)
6 Purpose of Supply:
7 Total Load applied for (in kW):
8 Type of Supply (Permanent / Temporary):
8(a) If Temporary supply, specify period of requirement: From (date):
To (date):
9 Please indicate whether you want to carry out the
works of laying service line and/or dedicated
distribution facility for the electricity supply
requisitioned (Yes/No)
10 Please indicate whether you want to install your own
CEA approved meter (Yes/No)
11 List of documents attached:
(a) Photograph to be affixed on application form (Yes/No)
(b) Identity Proof submitted along with this application form:
- If Applicant is an individual (i) Electoral identity card; (ii) Passport;
(Tick any one) (iii) Driving license; (iv) Ration card;
(v) Photo identity card issued by a Government Department;
(vi) PAN card;
- If Applicant is an organization Signature of competent authority (e.g. Branch Manager, Principal,
(Tick any one) Executive Engineer, etc) along with relevant resolution/authority letter of
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the institution concerned
(c) Proof of ownership of occupancy of premises for (i) Copy of sale deed or lease deed or in the case of agricultural
which electricity connection is required connections a copy of khasra / khatauni / khata nakal
(Tick any one) (ii) Registered General Power of Attorney;
(iii) Municipal tax receipt or Demand notice or other related document;
(iv) Letter of allotment.
(v) An applicant who is not an owner but an occupier of the premises shall
along with any one of the documents listed at (i) to (iv) above also furnish
a no objection certificate from owner of the premises
(d) Proof of current address (i) Electoral identity card; (ii) Passport;
(Tick any one) (iii) Driving license; (iv) Ration card;
(v) Photo identity card issued by any Government agency;
(vi) Statement of running Bank Account;
(vii) Water / Telephone / Electricity / Gas connection Bill;
(viii) Income Tax assessment order.
(e) Any other document as applicable (Please specify)
12 Particulars of any running connection/previous
connection on the name of the applicant
13 Any electricity dues outstanding in Licensee’s area of operation in consumer’s name: Yes/ No
14 Any electricity dues outstanding for the premises for which connection applied for: Yes/ No
15 Any electricity dues outstanding with the Licensee against any firm with which the consumer is associated as an Owner, Partner,
Director or Managing Director: Yes/ No
(For questions 13, 14 & 15 if the answer is ‘Yes’ in any case please provide details on a separate sheet)
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I/ We hereby declare that
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(a) The information provided in this application is true to my knowledge.
(b) I/ We have read the ……………………. Electricity Supply Code and agree to abide by the
conditions mentioned therein.
(c) I/ We will deposit electricity dues, every month, as per the applicable electricity tariff and other
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charges.
(d) I/ We will own the responsibility of security and safety of the meter, cut-out and the installation
thereafter.
Date: Signature of the consumer/ Authorized Signatory
Place: Name:
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Note: Apart from documents for identity proof, proof of ownership/occupancy of premises and proof of
current address, the following documents shall be attached with the application form
1. In case of a partnership firm – The applicant shall furnish the partnership deed and an
authorization in the name of the applicant for signing the requisition form and agreement;
2. In case of Public and/or Private limited Company – The applicant shall furnish a Memorandum
and Articles of Association and Certificate of Incorporation along with an authorization in the
name of the applicant for signing the requisition form and agreement; for tube wells, if required
3. Other documents applicable only for select consumer categories:
(a) Industrial consumers: Valid Industrial License/Registration as applicable
(b) Agricultural consumers: No Objection Certificate from competent government authority
(c) Non-Domestic Khokhas and Temporary Structure: No Objection Certificate for
khokha or temporary structure from the nagar nigam / nagar palika / nagar panchayat
/ gram sabha / gram panchayat / land development authority / land owning agency
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Acknowledgement
Application of …………………………………………………………………. (name of applicant) for
………….………………………………………. (purpose) is hereby received on …………….…. (date).
In this regard, the applicant is given a reference no. …………… to be used for all future correspondence.
Signature / Seal of Licensee’s representative
Name and Designation:
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