FORM -II FORM FOR LODGING COMPLAINT FOR INTERRUPTION/FAILURE OF POWER SUPPLY/LOW/HIGH VOLTAGE To be filled in by Consumer Sub-Division _________ Section _________ Consumer Account No. Ref.No._____ Complaint HPSEB) (To be given by 1. Name & full address of the consumer 2. Brief description of complaint 3. Date & time of lodging the complaint in the Complaint Centre 4. Date of lodging the current complaint 5. Any other information which the consumer intends to add Signature of the Complainant/Consumer Tear off (To be perforated) ........................................ ACKNOWLEDGEMENT TO BE FILLED IN BY THE HPSEB AND HANDED OVER TO THE CONSUMER Date: 1. Complaint Ref. No. (to be given by the HPSEB) 2. Applicant's name 3. Consumer A/C No 4. Received on date 5. Complaint received by 6. Brief detail of complaint 7. Target date to resolve the complaint Signature of Authorised Officer Designation: SEAL:
