Power Supply Application Form e

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New Project (veJeerve He´keÀuHe)
q Individual Connection (SkesÀjer pees[Ceer)
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I/We hereby make this application for New Project / Individual connection for supply of electrical energy at the premises mentioned below.
Keeueer veceto kesÀuesu³ee peeiesJejerue veJeerve He´keÀuHee®³ee / SkesÀjer pees[Ceer®³ee efJeÐegle HegjJeþîeemeeþer ceer / Deecner Depe& keÀjle Deenesle.

Landmark. ue@v[ceeke&À.
Suburb, City & Pin Code GHeveiej, Menj DeeefCe efHeve keÀes[
Phone / Mobile No otjOJeveer, ceesyeeF&ue ke´À.

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Correspondence Address if any. J³eJeneje®ee HeÊee Demeu³eeme.

Supply Voltage &

No. of Meters
Nos. Nos. Nos.
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bK
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for Mumbai North area customer
Deej-FveHe´Àe (meO³ee®ee ceerìj) GÊej cegbyeF& He´osMeer³e ie´enkeÀebmeeþer

E. Availability of Substation Space F&. meye mìsMevemeeþer peeiee GHeueyOe Deens? Yes nes³e
❏ No veener
❏

We agree to pay all applicable taxes, duties & other such levies like rent, property taxes etc. for the Substation Space Available is GHeueyOe
meyemìsMeve®eer peeiee
Substation space as required by various Governmental & local statutory authorities like MCGM etc.
ceer / Deecner mencele Deens / Deenesle keÀer mejkeÀej, mLeeefvekeÀ mebmLee Goe. ceneveiejHeeefuekeÀe ³eeb®³ee efveosxMeevegmeej Indoor Deele
❏ Outdoor yeensj Above flood level Hetj HeeleUerHeemetve Jej
❐
meyemìsMeve peeiesmeeþer ueeiet Demeuesues keÀj, Yeej DeeefCe Flej ®eepesxme JesUesJesUer Yeª / pecee keÀª. Basement leUcepeuee ❏
❏ Stilt efmìuì o Yes nes³e ❏ No veener

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I/We hereby agree : ceer / Deecner Heg{erue iees<ìermeeþer mencele Deens / Deenesle ë
a) To take supply of electrical energy from The Tata Power Company Ltd ar aforesaid premises situted De) Jej veceto kesÀu³eeHe´ceeCes ceeP³ee peeiesmeeþer cebpegj kesÀuesuee Yeej/uees[ l³eeHes#ee peemle ve Ieslee ìeìe Hee@Jej keÀ[tve Jeerpe HegjJeþe IesC³eemeeþer.
within their license area, not exceeding the sanctioned load of my/our installation as stated above. ye) JesUesJesUer Peeuesu³ee megOeejCeebmen ceneje<ì^ efJeÐegle efve³ee³ekeÀ Dee³eesiee®³ee efve³eceeJeueer, 2005 ceOeerue (Jeerpe HegjJeþe efve³eceeJeueer
b) To be bound by the MERC (Electricity Supply Code and Other Conditions of Supply) Regulations, 2005 DeeefCe HegjJeþ³eeefJe<e³eer®³ee Flej Meleer&) lejlegoerb®es Heeueve keÀjCes lemes®e l³eeceO³es efveos&efMele kesÀu³eevegmeej jgj#ee Deveecele jkeÌkeÀce YejCes.
& as amended from time to time & to provide necessary security deposit as specified therein. keÀ) GÊej cegbyeF& He´eosefMekeÀ ie´nkeÀebmeeþer 15 Dee@keÌìesbyej 2009 ®³ee kesÀme veb. 50/2009 ®³ee leelHegjl³ee ®esbpe DeesJnj®³ee ceneje<ì^ efJeÐegle
c) To be bound by the provisions of MERC order dated 15th Oct. 2009 in Case No. 50 of 2009 pertaining to efve³eecekeÀ ceb[Ue®³ee DeeosMee/Dee@[&jHe´ceeCes meO³ee®³ee efJelejCe kebÀHeveer®eer mebHegCe& DeefmlelJeele Demeuesueer efJelejCe J³eJemLee JeeHejueer peeF&ue.
interim arrangement for Mumbai North area customer chageover by usage of network infrastructure of [) 50 kesÀ[yu³eg / 63 kesÀJeerS Hes#ee peemle cebpetj YeejemeboYee&le Jeerpe HegjJeþe keÀjeje®³ee lejlegoerbvee yeebOeerue DemeCes DeeefCe (pesLes meyemyesMeve
Existing Distribution License and any further MERC orders / regulations or otherwise regarding the same. DeeJeM³ekeÀ Demesue lesLes) meyemìsMevemeeþer®³ee peeiesmeboYee&leerue ìeìe Hee@Jejves kesÀuesu³ee keÀjeje®³ee lejlegoerbvee yeebOeerue DemeCes
d) To be bound by the provisions of the Power Supply Agreement (for all sanctioned load of 50 KW / 63
DeeJeM³ekeÀ Deens.
KVA and more) & Substation Space Agreement (where substation is required) to be executed with Tata Power.
e) To Pay for the said supply at the prevailing tariff rates and also to pay the charges based on the
F) GhejeskeÌle Jeerpe HegjJeþ³eemeeþer SkesÀjer pees[Ceermeeþer ueeieg Demeuesu³ee ojeves DeeefCe ceneje<ì^ efJeÐegle efve³eecekeÀ ceb[Ueves ìeìe
Schedule of Charges / Rates for individual connections approved by MERC for Tata Power from time to time.
Hee@Jejuee Mes[³egue Dee@HeÀ ®eepes&me®³ee DeeOeejs JesUesJesUer cebpegj kesÀuesu³ee DeekeÀeje®es / oejves Hewmes osCes.
f) That change of name / purpose / classification category shall not be permitted at the of name, purpose, HeÀ) GÊej cegbyeF& He´eosefMekeÀ ie´enkeÀebmeeþer veeJeeleerue yeoue, Gefodo<ì yeoue efkeÀbJee Jeie& yeoue ns ®esbpeDeesJnj®³ee JesUsme nesGÀ MekeÀCeej veener,
category at a later date of continue to abide by the conditions of changeover even after change of veeJeyeoue Jee Jeie&Jeejerleerue yeoue keÀjC³eele Deeu³eeveblejner lemes®e p³eebvee veeJeeleerue / Gefoo<ì / Jeie&Jeejer yeoue veblej keÀjeJe³ee®es
his/her name or the purpose or the classification category. Demeleerue l³eebvee ®esbpeDeesJnj®es meJe& efve³ece HeeUeJes ueeieleerue.
g) Customers availing supply through R-Infra agree to pay the necessary wheeling losses/wheeling peer) pees keÀesCeer ie´enkeÀ Deej-F&vHeÀe vesìJeke&ÀÜejs peerJeve HegjJeþe Iesle Deensle, l³eebvee SceF&Deejmeer ®³ee efve³eceevegmeej JesUesJesUer efJnefuebie
charges as approved by MERC from time to time. uee@mesme Je efJnefuebie ®eepes&me ueeieg nesleerue.

(Iejiegleer ie´enkeÀebmeeþer ueeiet veener)

Note :
• Cheque for relevant payments as per the “Guidelines” to be prepared in favour of “The Tata Power Company Limited”.
• Please do provide your Mobile Number & Email Address to enable us to send you instant SMS & Emails
regarding your application status & processing, billing details and such value added services. Please be
assured that the same will not be shared with any other entity or be used adversely.
• For All Queries Please Contact Call Centre at 1-800-209-5161 (Toll Free) or 67172730
• Please refer Guideline for further information.
met®evee ë
• legce®eer jkeÌkeÀce Yejles JesUer ’ieeF&[ueeF&vme“ ®³ee DeeOeejs legce®ee OeveeosMe ’o ìeìe Hee@Jej kebÀHeveer efueefceìs[“ ³eeb®³ee veeJes efueneJee.
• ke=ÀHe³ee legce®ee ceesyeeF&ue vebyej ³ee F&-cesue Deecnebuee SmeSceSme ®³ee DeeOeejs HeeþJee.
• ®eewkeÀMeermeeþer keÀe@ue mesWìj 1-800ö209-5161 (ìesU He´Àer) efkeÀbJee 67172730
• DeefOekeÀ ceeefnleermeeþer ieeF&[ueeF&vme Hene.
 Annexure to the Power Supply Application Form e
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Microwave

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❑Ration Card (for Residential Consumers only)
❑Voter ID Card (for Residential Consumers only)
❑Passport (For Residential Consumers only)
❑Purchase / Sale Agreement with Builder / Previous Owner
❑Owners NOC with Leave & License / Lease Agreement (if
applicant is not premises owner)
❑Developer Agreement with Land Owner / Occupier / Govt. Agency
❑Society Share Certificate / Maintenance Bill or Receipt /
Society Letter (applicable for changeover applicants)
❑MCGM / MBMC Property Tax Bill / Receipt
❑Govt. Issued Property Card or 7/12 Extract / IOD
❑MIDC / SEEPZ Order / Letter of Allotment / Approval Lease Agreement.
❑Society Registration or Society PAN Card Copy for Common
Services like Lift, Staircase, Waterpump, etc.
Voter’s Identification Card Location Map & Plot Plan of Site (for New Projects)
Approved Plan by relevant Authority (for New Projects)
Passport
PAN Card 50 KW / 63 KVA )
Driving License
Photo Pass (Recognized Organization
Photo Identity Card)
Photocopy of latest paid R-Infra energy bill (front & back side)
Sr. Citizens Identity Card issued by Govt.
(for changeover application)
Collector / Govt. Authorised Photo ID Written application on society letter head with sign and stamp
(for Society Common Services like Lifts, Staircase, Waterpump, etc.)
Photo ID in Purchase / Sale Agreement

Note : a) Photocopies of the documents to be submitted along with the application should be self attested.
b) Documents Pertaining to energization may to be submitted prior to energization.
PSAF Form Rev. No. 1 Dt. 20th July 2010 Print Dt. 23rd July 2010