PSEB CS-I(R) PUNJAB STATE ELECTRICITY BOARD 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(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. (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:- i. Certified copy of the Articles of Association/memorandum ii. Certified copy of the Incorporation of the company iii. Certified copy of the partnership deed. iv. Certified copy of registration of the firm by the Registrar of the firms. v. Certified copy of Constitution of the society/trust. vi. Certified copy of the registration of the society by the Registrar of Societies. vii. Special power of attorney for the authorized signatory duly notarized. viii. Certified copy of the resolution authorizing the signatory to sign on behalf of the company. ix. Certified copy of the NOC from PPCB. x. Certified copy of NOC from PUDA. xi. Undertaking that the company or its sister concern is not involved in theft case. xii. Undertaking that no court case or dispute is pending. xiii. Undertaking to the effect that the consumer shall not claim damages in the event of fluctuation on the system. xiv. Undertaking that no other connection is running in the same premises. Issued to Sh/M/s...........s/o........... Signature of consumer clerk
