Three phase undertaking

Address:

Date:

To,
The chief Engineer
Reliance Energy Limited
Kandivali West
Mumbai 40067

Dear Sir,

Sub: Undertaking for electric supply at

Ref No:

I / We the undersigned hereby request you to kindly sanction the electric connection at the above mentioned address as required for the purpose
mentioned in the requisition form.

I / We also undertake to use the connection as requisitioned. If at any time, the connection is found to be misused, you may disconnect my / our
supply without any prior intimation to me / us.

Thanking you,

Yours faithfully,

(Applicants Signature)
Applicants Name