NEW CONNECTION APPLICATION FORM ANNEXURE - 1 1

Please fill the form in CAPITAL LETTERS (please on the appropriate box)

Please attach a recent

Form Serial No.
passport size
colour photograph of
Notification No. applicant (Self
attested)
CA No.

CONNECTION SERVICE(S) REQUIRED Senior Citizen Blind Defence Personal

New Connection Connection Particular Charges
for Existing Connections
Permanent Connection Prepaid Post Paid
Reconnection (Dormant Supply)
Temporary Connection (Regular supply / Connection)
Period of Temp Connection (Max. 1 year)
Temporary Connection (Short term Functions) From : __________________________ to ________________________
1 GENERAL PARTICULARS
Name of Applicant / Organisation

Title Mr. Ms. Dr. Prof. Others Age Years Date of Birth

Name of Applicant / Organisation

Director / Partner / Trustee

Father's/Mother's/Husband's Name Mr./Ms.

Type of Accomodation Owned Rented/Lease Company Provided Govt. Provided
Govt House/DDA Flat/CGHS Flat J.J. Cluster Others
2. Complete Supply Address

House No./Flat No./Shop No. Plot No./Khasra No.

Portion Floor Street Name

Area/Location City

Pin Phone No. Mobile

Landmark Pole No.
E-mail

Name of Premises (if any)

3. Billing address (where bill is to be sent/is being sent)
Same as above If different, please specify below

House No./Flat No./Shop No. Plot No./Khasra No.

Portion Floor Street Name

Area/Location City

Pin Phone No. Mobile

Landmark Pole No.
E-mail
CIN No. : U40109DL2001PLC111526, E-mail : tpddl@tatapower-ddl.com, Website : www.tatapower-ddl.com

ACKNOWLEDGMENT RECEIPT
FORM SERIAL NO. :___________________

NOTIFICATION NO. : __________________ FILE PREPARED BY :____________________

This acknowledgment is only to intimate you that your application has been received and request will be deemed to be accepted only after
completion of commercial formalities and requisite compliances.

In case of further assistance, please contact at TATA Power-DDL 24x7 Sampark Kendra Toll Free Number 19124 / In case
number is not reachable or calling from outside Delhi, please dial 1800-208-9124 or E-mail us at customercare@tatapower-ddl.com
Request status can also be checked through our Mobile App: TATA Power-DDL Connect
CIN No. : U40109DL2001PLC111526, E-mail : tpddl@tatapower-ddl.com, Website : www.tatapower-ddl.com
 4. Category for Electricity Usage (As per applicable Tariff Schedule) 2
Domestic Category-Residential/Hostels*/Hospitals*/Educational
(i) (vii) DJB
Institutions*/Religious/Charitable*/Others

(ii) Non domestic-Banks/Chemist/Tailors/Others (viii) Railway Traction

(iii) Industrial (ix) DMRC
(iv) Agricultural (x) Advertising (No. of Hoardings)
(v) Mushroom (xi) Temporary Supply
(vi) Public Lighting
Note : the applicant shall refer the applicable tariff schedule for correct tariff Category. In case of any doubt, the applicant shall seek help
of the licensee. *based on the funding pattern as per tariff schedule.

5. PAN No. (For correct deduction of TDS, if any)

6. Purpose of supply (e.g. Shop/House/Factory/Godown/Parking etc.

7. Total load applied for kW kVA

8. Please indicate whether you want to purchase your own CEA Yes No
approved meter having additional features as approved by the
Commission (Note - if yes please Provide Details)
9. List of documents attached:
A. Identity Proof submitted along with this application form (ii) Proof of ownership or occupancy of premises for which
> if applicant is a person (tick any One) electricity connection is required (tick any one)
i. Electoral identity Card i.
Certified copy of title deed
ii. Passport ii.
Certified copy of registered conveyance deed
iii. Driving License GPAiii.
iv. Ration card having photograph iv.
Possession letter/Allotment letter
v. PAN card In case of tenant
v.
vi. Aadhar card a). Rent receipt/Lease agreement
vii. Photo identity card issued by any government agency b). No Objection certificate from Landlord
If applicant is an organization (tick Applicable)-Certificate of c). Proof of ownership of Landlord
incorporation/registration issued by the Registrar. vi. Others
10. Declaration Form (Attached) Yes No
Note : For bonafide consumers residing in JJ clusters or in other areas with no specific municipal address, the licensee may accept either
ration card or electoral identity card mandatorily having the same address as proof of ownership / occupancy of premises.
PARTICULARS OF NAME OF APPLICANT AS APPEARING ON CHEQUE & CHEQUE DETAIL FOR SECURITY REFUND.
Name of Applicant Account No.

Name of Bank Name of Branch

Cheque No.

PAYMENT PARTICULARS

Cash Receipt No./DD/Cheque No. Date

Bank

Branch
Credit Card - I here by authorise to debit my Visa Master Card Diners American Express

Card No. Valid thru for Rs.

TATA Power-DDL Official Signature & Date Customer's Name & Signature

Employee Code

CIN No. : U40109DL2001PLC111526, E-mail : tpddl@tatapower-ddl.com, Website : www.tatapower-ddl.com

Documents Submitted*
S. No. Documents Check
1. Ownership proof/Occupancy Proof
2. ID Proof
3. NOC
4. Miscellaneous (Court orders, etc.)
*All the documents submitted are subject to the verification and authentication.
*Commercial formality if found incomplete, additional documents / requirement may be solicited.
CIN No. : U40109DL2001PLC111526, E-mail : tpddl@tatapower-ddl.com, Website : www.tatapower-ddl.com
 3

TATA POWER DELHI DISTRIBUTION LIMITED

(A Tata Power and Delhi Government joint venture)

Declaration
I,_________________________________________Son/Daughter/Wife of__________________________
Resident of ____________________________________________________________________________
(hereinafter referred to as 'Applicant", which term shall mean and include executors, administrators, heirs,
successors and assigns), do hereby swear and declare as under:
Or
The _________________________________________________, a company incorporated under the provision of
the Companies Act, 1956 Or as amended, having its registered office at,____________________
_____________________________________(hereinafter reffered to as "Applicant" which expression shall, unless
repuguant to the context of meaning thereof, include its successors and assigns), through its Authorised
representative Mr. ______________________________ do hereby swear and declare as under:
Or
A sole proprietorship/a partnership firm having its office at ________________________________________
_______________________(hereinafter referred to as the applicant which unless the context otherwise provides
includes its successors and assigns), through Mr. ________________________________________
___________________________________, who is a partner or an authorized representative do hereby swear and
declare as under:

That the Applicant it a lawful occupant of the premises at __________________________________________

(hereinafter the "Premises").

That the Applicant has requested the Licensee to provide a service connection at the above-mentioned premises in
the Applicant's name for the purpose mentioned in the application form.

That in furnishing the present Declaration, the Applicant has clearly understood that should any of the statements in
this declaration prove to be false or incorrect at any later stage, the Licensee shall be within his lawful right to
disconnect supply to the premises without any prior notice and proceed to adjust electricity supply dues payable by
the applicant against consumer security deposit and/or recover the same in accordance with Law.

That the Applicant has complied with all requirements under all statute for the time being in force and the applicant
himself/herself shall be held legally responsible for any issue arising out of any such noncompliance for which the
Licensee may initiate action in accordance with applicable Law.

That I, the Applicant hereby agrees and undertake :

1. That in case the Applicant is not the sole owner of the premises, no objection certificate for seeking
electricity connection from the co-owner has been obtained.
2. To indemnify the Licensee against all proceedings, claims, demands, costs, damages, expenses that
the Licensee may incur by reason of a fresh service connection given to the Applicant.
3. That to the best of applicant's knowledge, all electrical works done within the premises are as per
Central Electricity Authority (Measures relating to safety and Electricity Supply) Regulations, 2010 as
amended from time to time.
4. That the internal wiring at the premises has been tested by a Licensed Electrical Contractor and the test
certificate is available with the applicant.
5. *That the building has been constructed as per prevalent building Bye-laws and the total height of the
building.
(i) does not exceed 15 (fifteen) meters on the date of seeking service connection; Or
(ii) Is more than 15 (fifteen) meters and fire clearance certificate is available with the applicant.
6. *That there is a provision of lift in premise and the applicant has obtained the lift fitness certificate from
the Electrical Inspector for the lift in the said premises and same is available with the applicant.
7. That the applicant has applied for the correct category of tariff as per the applicable tariff schedule. For
either of the following categories of connection, the applicant has the relevant documents available
with him.

*Applicant for selected consumer category

a) Industrial
Valid industrial License/Factory License/Lal Dora Certificate is case of rural village
b) Agricultural Consumer
 4
i) Certificate of Residence From Block Development Officer
ii) No Objection Certificate from Development Commissioner / Block Development Officer
Delhi Jal Board for tube wells.
c) Non-domestic for khokhas and temporary structure
i. TehBazari Receipt Number
ii. No Objection Certificate for Khokha/Temporary Structure for single delivery supply
d) Charging station for electric vehicles
An undertaking by the applicant that the charging station for electric vehicles is as per the
specifications as may be specified by Central Electricity Authority or Bureau of Indian Standards
from time to time.
8. The above referred applicable documents/Certificates indicated at various points are available with me
and can be inspected by the Licensee at any time. In case of any failure to produce the same, the
Licensee may disconnect the connection granted owing to such failure reluctance on my part to
produce/allow the inspection of said documents / Certificates.
9. That I will provide a copy of any of above applicable documents to the Licensee pursuant to request of
any external government agency, judicial forum or any other authority seeking such information.
10. That my industry / trade has not been declared to be releasing obnoxious hazardous/pollutant by any
government agency and that no orders of any court of judicial authority would be breached by running
of my industry / trade or granting any electricity connection to the same. The Licensee is indemnified
against any loss accrued by the applicant on this account.
11. The Applicant further agrees to indemnify and hold harmless, the Licensee, in case of any injury or
incident on account of any fault in electricity work in the premises. The Licensee shall not be liable for
any mishap or incident occurring at the premises to the applicant on account of any
faulty/defectice/inferior quality wiring at the premises for which the connection is being applied.
12. To pay the electricity consumption bills and all other charges at the rates set out in the Licensee's Tariff
Schedule and miscellaneous charges for supply as may be in force from time to time regularly as and
when the same becomes due for payment.
13. To deposit the additional security deposit and additional service line cum development (SLD) charges,
if any from time to time based on the prevailing Orders/rules, directions and Regulations of the
Commission.
14. To abide by the provision of the Electricity Act, 2003 all applicable laws, conditions of Supply/Tariff
Orders and any other Rules or Regulations as may be notified by the Commission, as applicable from
time to time.
15. That Licensee shall be at liberty to adjust the electricity consumption charges due/outstanding along
with any other charge against the Consumer Security Deposit paid by the Applicant, in the event of
termination of the agreement prior to expiry of the contracted period or in case of any contractual
default as per provisions of regulations/rules/orders/directions of the Commission.
16. That as per Delhi Electricity Supply Code and Performance Standards, 2017 or as amended from
time to time, I shall provide suitable and adequate space for installation of the meter/electriclty
equipments where the Licensee may have ready access to the same.
17. To allow clear and un-encumbered access to the meters for the purpose of meter reading and it's
checking etc.
18. That the Applicant would let the Licensee disconnect the service connection under reference, in the
event of any default, non-compliance of statutory provisions and in the event of a legally binding
directive by Statutory Authority (ies) to effect such an order. This shall be without prejudice to any other
right of the Licensee including that of getting its payment as on the date of disconnection.
19. I have installed or shall install an Earth Leakage Circuit Breaker device(ELCB)/MCB for single
phase connection & 4 pole MCCB/ELCB/RCCB for three phase connection before using power
supply service at my aforesaid premises where electricity connection has been sought. I too
declare that, earthing is done at applied premise and equal load is distributed on all phases. On
my failure to install the said device(s),I shall be solely held resposible for any mis-happening,
safety breach/ incident due to negligence etc. at the aforsaid premise. TATA Power-DDL shall be
free to proceed with cancellation of electricity connection and disconnection etc.
20. All the above declaration given by the Applicant shall be construed to an Agreement between the
Licensee and the Applicant.

Signature of the Applicant Name of witness

Name of the Applicant

SIGNED AND DELIVERED

In presence of witness
Name of witness

*Select whichever is applicable