Annex 5.1 (Ref. Clause 5.19) Meter Related Complaints or Testing of Meter Complaint Ref. No.: (To be given by Licensee) 1. Name, address and telephone No., if any of the complaint. 2. Book Number/Service Connection Number 3. Brief description of the complaint-Burnt out/completely stopped/Fast/Seal broken/Testing of Meter 4. Initial cost of meter was borne by consumer/Licensee 5. Complainant desires to provide/has provided a new meter for replacement (Yes/No) 6. Any other information Date: (Signature of Applicant) ----------------------------------Cut From Here-------------------------------- (For Office Use) 1. Site verification report Signature (JMT/SMT) 2. Comments of AE (Meter) Signature E (Meter) 3. Reference of informing the consumer within seven days ----------------------------------Cut From Here-------------------------------- ACKNOWLEDGEMENT TO BE HANDED OVER TO THE CONSUMER 1. Complaint reference No. (To be given by Licensee) 2. Complaint received by (Name & Designation) 3. Complaint receiving date 4. Target time to resolve Signature of Licensees