PUNJAB STATE ELECTRICITY BOARD REQUISITION FORM FOR INDUSTRIAL/BULK SUPPLY (For Loads Exceeding 500 KW) Requisition No...... Date........... To AE/AEE/XEN (Ops) P.S.E.B Sub Division ......... 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 (Along with 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. Earnest Money ____________________ B.A. -16 No. ____________________ Date ____________________ _________________________________ (Signature of Applicant) Present Address ___________________ _________________________________ _________________________________ Issued to Shri/ Smt./ M/s _____________________________ s/o _______________
