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REQUISITION FORM FOR INDUSTRIAL/BULK SUPPLY (FOR LOADS EXCEEDING 500 KW)
Requisition No._________________ Date:__________________ To SE/Dy. Chief Engineer/Op. P.S.E.B., Circle, ___________________
Sir, I/We hereby request you to supply energy for the following premises owned/occupied by me/us. Load/Contract demand and other particulars are detailed below:- 1. Motive /Industrial Load(KW) 2. General Load(Light, fans, heaters, refrigerator etc)(KW) 3. Load for residential colony (KW) 4. Total Load(KW) 5. Contract Demand(KVA) 6. Transformer Capacity(KVA) 7. Supply voltage 8. In case of extension in load, Details of present load/ Present Contract demand 9. Type of Industry 10. Capacity of furnace(Arc/Induction) transformer(KVA) and voltage ratio. 11. Details of premises(Alongwith Map) 12. Distance from Sub-Station 13. Special feeder if required 14. Any other details
I/We request that permission to file requisition for above Load/Contract Demand may be granted.
(Signature of Applicant) Full Address:_______________________ ___________________________________ ___________________________________ Earnest Money_________________________ BA-16 No.______________________________ Dated:________________________________
Issued to Sh//M/s._________________________________S/o_______________________
Signature Consumer Clerk
List of documents to be submitted:- 1. Certified copy of the Articles of Association/memorandum 2. Certified copy of the Incorporation of the company 3. Certified copy of the partnership deed. 4. Certified copy of registration of the firm by the Registrar of the firms. 5. Certified copy of Constitution of the society/trust. 6. Certified copy of the registration of the society by the Registrar of Societies. 7. Special power of attorney for the authorized signatory duly notarized. 8. Certified copy of the resolution authorizing the signatory to sign on behalf of the company. 9. Certified copy of the NOC from PPCB. 10. Certified copy of NOC from PUDA. 11. Undertaking that the company or its sister concern is not involved in theft case. 12. Undertaking that no court case or dispute is pending. 13. Undertaking to the effect that the consumer shall not claim damages in the event of fluctuation on the system. 14. Undertaking that no other connection is running in the same premises.
PUNJAB STATE ELECTRICITY BOARD APPLICATION AND AGREEMENT FOR (For Loads up to 100 KW other than DS/NRS categories) PSEB CS-I Sr. No???.(to be machine numbered)
For Official use only 1. Name of Sub division_________________ 2. Applicants Name/Designation____________________ 3. Is applicant a member of Scheduled Caste/Back ward Classes___________ 4. Security Receipt No. and Date ____________________ 5. Current Account No. (If any) ______________________ 6. a) Present connected Load (if any) ________________ b) Load applied ___________________ c) Total Load _____________________
?????????????????????????????????????.. (To be completed and signed by Applicant) To The__________________ Punjab State Electricity Board, ________________________ I/We hereby agree to take from Punjab State Electricity Board (herein-after referred to as the Board) at the premises stated below, a supply of electrical energy not exceeding the connected load of my/our installation as below, and I/We hereby further agree to pay for the said supply in accordance with the relevant tariff, as amended from time to time and also to pay for all such other charges as may become due by me/us to the Board from time to time at rates laid down in the Schedule of General and Service Connection Charges prescribed by the Board from time to time. I/We further agree that I/We shall, as and when required by the Board to do so, lodge with the Local office of the Board Security Against Consumption as per the rates specified by the PSEB in Schedule of General & Service Connection Charges. And I/We hereby declare that we shall be bound by the Electricity Supply Regulations including Schedules of Tariffs and Schedule of General and Service Connection Charges approved by PSERC and also the provision of the Electricity Act-2003 and rules & regulations made thereunder.
I/We further require you to supply me/us with the necessary meter/meters on hire in terms of Section 55 of Electricity Act, 2003. I/We agree to give you such security as may be required for the price of the meter/meters whenever called upon to do so.
Description of Premises:- house/ship/premises No????..Locality??????..Town/Village?????
I/We also declare that I/We am/are owner/landlord of the premises or my/our/landlord/owner agrees to my/our taking the said supply and his/their written consent is attached herewith. or I/We are the lawful occupier/s of the premises but it has not been possible for me/us to obtain consent from the landlord and I/We herby agree to keep the PSEB indemnified and harmless against all claims made and action and proceedings taken up by the landlord or any person claiming through or under him by reason of giving of this electric connection by the PSEB to me/us.
2. I/We hereby agree that I/We shall abide by the power cut restrictions/peak load hours restrictions.
3. It is disclosed that I/We am/are major.
4. The authorized representative of the Board can check energy consuming apparatus at my/our premises at any time. ????????????????????????????????????. Schedule of energy consumption apparatus: ????????????????????????????????????..
Total connected load???????.KW Supply Voltage????????..V/KV Signature of witnesses?????????? Signature of Applicant??????? Name?????????????.. Name??????????????. Address????????????.. Present Address?????????.. PSEB Account No???????? ????????????.. Dated??????????????..
Signature of representative of PSEB with designation.
Note:- Applicant will sign in the presence of XEN/AEE/AE/JE/RA/ARA and in case of Sub-Office Addl. AE/JE. Officer will ensure that this form has been filed in correctly. He will sign after satisfying himself that form has been signed in his presence. Dated???????????
Signature of officer/official verifying the correctness of the application.
Name:???????? Designation:?????. FOR OFFICE USE ONLY
General Load??????????. Motive Load if any????????.. Total connected load????????? Watts/Kilowatts/LT(400 Volts)/HT (11 KV)
FORM NO.CS-1-A ANNEXURE-I
Application and Agreement Form cum Consumer Case for Release of General Service Connection (Category: DS/NRS)
Name of Applicant/Consumer:_______________________________________ Complete Address:________________________________________________ ________________________________________________________________ Sub-Division:_____________________________________________________
Price Rs.50/- Account No.___________
GUIDELINES FOR THE PROSPECTIVE CONSUMER REGARDING PROCESSING OF THE CASE FOR RELEASE OF ELECTRIC CONNECTION 1. PSEB shall entertain only such prospective consumers who are ready to take permanent connections and not those who have started construction of their premises. 2. The applicant/consumer shall contact CC/RA to obtain an application and agreement form at the prescribed rate. 3. The application and agreement form duly filled alongwith test report shall be submitted to the CC./RA for further process. 4. The application and agreement form shall be checked by CC/RA in the presence of the applicant/consumer and ensure that all the columns have been filled in correctly and in case of any deficiency the same shall be got completed from the applicant/consumer. 5. RA shall put up application and agreement form to the SDO/AEE/XEN(DS.) for attestation of the photo of the applicant/consumer pasted on the form. 6. RA shall give details of amount to be deposited by the applicant/consumer with the cashier. 7. The applicant/consumer shall deposit the required amount with the cashier who will issue a printed receipt to the applicant/consumer in token of amount received. 8. The applicant/consumer shall keep the original receipt with him and leave the case file with the cashier. Formalities on the part of the applicant/consumer shall be over. 9. The electric connection shall be released within seven days subject to availability of material (maximum 30 days) and in case connection is not released during this period, he may contact SDO/AEE/XEN (OP.) 10. In case of extension in load applied by the existing consumer, it shall be considered deemed released on the day it is applied. 11. Single Phase electric connections (DS/NRS) shall be released up to 10KW load only and above that three phase connections shall be released. 12. How to work out connected load by the applicant/consumer:-
Note:- (i) The Load of air conditioners/AC packages/centralized AC systems of standard shall be taken as per their nameplate. For non standard window type air conditioners the total load shall be taken as 2.5 KW. (ii) The load of geysers connected through power sockets only and the additional load as per rating/name place is not to be counted for the purpose of computing the total connected load. (iii) The load, motors etc. shall be counted as per the name place.
PUNJAB STATE ELECTRICITY BOARD APPLICATION AND AGREEMENT FORM (For General Service Connections) Category ?DS/NRS To The Sub Divisional Officer, ____________Sub-Division, PSEB, ___________________________
Sub: Contract Agreement for release of a new connection/extension /reduction in load. Account No.__________________(in case of extension/reduction in load only)
1. I/We hereby agree to take from Punjab State Electricity Board(hereinafter referred to as the Board) at the premises stated below, a supply of electrical energy not exceeding the connected load of my/our installation as below, and I/We hereby further agree to pay for the said supply in accordance with the relevant tariff as amended from time to time and also to pay for all such other charges as may become due by me/us to the board from time to time at rates laid down in the Schedule of General and Service Connection Charges prescribed by the Board from time to time. I/We further agree that I/We shall as and when required by the Board to do so, lodge with the local office of the Board Security Against Consumption as per specified rates. I/We hereby declare that we shall be bound by the Electricity Supply Regulations including Schedules of Tariffs and Schedule of General and Service Connection Charges approved by PSERC and also the provision of the Electricity Act-2003 and rules & regulations made there under. 2. I/We further require you to supply me/us with the necessary meter/meters on hire in terms of section 55 of the ElectricityAct, 2003. I/We agree to give you such security as may be required for the price of the meter/meters whenever called upon to do so. I/We agree to pay monthly rent for the meter(s) as fixed by the Board from time to time. 3. Description of Premises: House /Shop/ Premises No.______Locality_____________Town/ Village/ City_______________Pin Code_______ Telephone No._____________________ 4. I/We declare on oath as under:- i. It is disclosed that I/We am/are major. ii I/We, am/are owner/landlord of the premises or my/our landlord/owner agrees to my/our taking the said supply from the Board. OR I/We are the lawful occupier/s of the premises but it has not been possible for me/us to obtain consent from the landlord and I/We hereby agree to keep the Board indemnified and harmless against all claims made and action and proceedings taken up by the landlord or any person claiming through or under him by reason of giving this electric connection by the Board to me/us. iii I/we hereby agree that I/We shall abide by the power cut restrictions/peak load hour restrictions imposed by the State Government/Board from time to time. iv My/our premises are within/outside the municipal limit. v. My/our premises are ready and electrical installation complete in all respect to receive power. vi` I/We shall provide space for the installation of motor at the main entry of the premises. The MCB shall be provided by me/us. vii The authorized representative of the Board can check energy consuming apparatus/installation at my/our premises at any time. viii There is no other electric connection running in the above premises. OR One No. DS/NRS electric connection is already existing in the above premises and I/We want to take second connection for which I/We are ready to pay highest slab of tariff. ix There is no defaulting amount/theft case/pending court case of the board against my/our above premises. x I/We do not have any dispute of any amount with the Board anywhere in Punjab. OR I/We have a dispute of Rs.__________with Board for which compliance of instructions of Board on the subject has been made. xi The above premises is more than 5m /10m /30m /100m away from the road reservation of Municipal Road./Schedule Road/Bye-pass. xii I/We have applied this electric connection for domestic purpose and no business activity shall be carried out in this premises without prior permission from the Board. OR i/We have applied this electric connection for non residential purposes only. 5. SCHEDULE OF ENERGY CONSUMING APPARATUS
6. I/We am/are enclosing herewith Wiring Contractors test report alongwith A&A form. A copy of Challan of CEI(Pb) and permission accorded by him is also enclosed (wherever applicable). I/We also certify that I/We will not effect any change in wiring /connected load as given in the test load. VERIFICATION: I/we also undertake that the above information is correct and in case I/We violate any undertaking/instructions or any other information is found to be false at any stage, my/our electric connection may not be released and if released, it may be disconnected without prior notice and all charges deposited by me/us be forfeited. ___________________ Signature of the applicant(s) Date:__________ Name & Address:_______________ _____________________________ For and on behalf of the Board
____________________ Signature of the SDO/AEE/XEN/Sr.XEN/SE/Dy.CE(DS) Date:__________________ Official seal (To be signed after release of load) FOR OFFICE USE ONLY A. ACTION BY R.A.
Whether new/extension/reduction in load. Existing Account No.___________ Existing connected load_____________KW,Applied Load+ _______________Total Load_______KW Amount to be deposited on account of following:- (i) Security Against Consumption Rs.__________________________ (ii)Meter Security Rs.__________________________ (iii)Service Connection Charges Rs.__________________________ (iv)Special/Any other Charges Rs.__________________________ Total Rs.__________________________ Cashier please accept Rs._________________(in words)Rs.________________________________ Dated:____________________ Signature of R.A. Name:___________________ (NOTE: Test report received with the A&A form to be pasted in the case file).
B. ACTION BY CASHIER
Received Rs.____________(in words)Rs._________________________________________________ vide RO-4/BA-16 Receipt No._______________________Book No.____________Dated___________
Signature of Cashier Name:____________________
(NOTE: RO-4/BA-16 receipt shall be issued by the cashier to the applicant/consumer and shall send the case to Consumer Clerk. The consumer clerk shall make entry in the service connection register and pass on the case file to R.A )
C. ACTION BY CONSUMER CLERK
Entered in Service Connection Register at Serial No._____________date________________
Signature of CC Name:_________________
D. FOR FURTHER ACTION BY RA
Certified that the applicant has completed all the formalities and has deposited the required amount. Work for release of his connection/extension in load maybe taken in hand against the following sanctioned estimate.
I Sanctioned Estimate No.__________Date____________Operative period_________________ ii Sanctioned amount of the estimate Rs.__________________________________ iii Amount already spent Rs.__________________________________ iv Balance unspent amount Rs.__________________________________
Date:_______________ Signature of R.A. Name:__________________
E. FOR ORDERS BY SDO/AEE/XEN(OP) INCHARGE
i Issue Service Connection order. ii The work may be carried by Shri._________________________________JE.
Signature of SDO/AEE/XEN(OP) Name:________________________
F. ISSUE OF JOB ORDERS BY RA
Service Connection Order No._________________________Dated________________in the name of Shri__________________________________JE issued.
Signature of R.A. Name:____________________ Dated:____________________
Signature of JE_______________________ Name_______________________________ Date:_____________
G. INFORMATION/CERTIFICATES TO BE RECORDED BY THE JE FOR RECORD. i The load has been checked at site and found to be___________KW. ii The connection/extension/reduction in load has been released on______________ iii The connection/extension/reduction in load has been released from__________(Name of Transformer) iv The connection/extension/reduction in load has been released from__________(Name of Feeder), Code No.__________. v The entry has been made in connected load register. vi Location of the premises of the applicant/consumer.
vii Certified that the connection has been released without any violation of PSEB rules and regulations. OR Connection has not been released because of the following violations of rules. a. b. c d. viii Details of Material used for release of connection and its value:
Total Value of the material installed. Rs.______________________ Labour Charges Rs.______________________ Departmental Charges: Rs.______________________ Total Amount debited to the estimate Rs.______________________
ix Details of PSEB/PVT. Meter installed.
Date:_______________ Signature of J.E.:______________ Name:____________________________
H. CERTIFICATE IN RESPECT OF CHECK ENTRIES TO BE RECORDED BY JE-1/ AAE/SDO Quantity of material shown as used has been measured and found to be correct except the following:-
Date:____________________ Signature of JE-1/AAE/SDO Name:____________________
I. CHECK ENTERIES TO BE RECORDED BY SDC
Certified that the above particulars have been checked and entries compared with IWR/ EMB. No.________________Page_________ ME-2 Register No.______________. Sr.No.______________Page_____________and found correct.
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