TATAPOWER-DDL

TATAPOWER DELHIDISTRIBUTION LIMITED

Declaration
Son/Daughter/wife ofSHR NARESH JTNGMResident of
KH.N-1920,NNGAR SOeNA OHAGA,RITHALAQELHI-llvo4 (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 provisions 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 or meaning thereof, include its successors and
assigns), through its Authorised representative Mr. do heretby swear and declare as under:

Asole proprietorship/a partnership firm having its office at (hereinafter

That the Applicant not 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 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 ofthe statements in this declaration
prove 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 allrequirements under allstatute for the time being in force and the Applicant himself /herself
shallbe 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 undertakes:

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 afresh service connection given to the Applicant.
3 That to the best of applicant's
knowledge, all electricalworks 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
does not exceed 15 (fifteen) meters of the date of seeking service
ii) is more then 15 (fifteen) meters and Fire Clearance certificate is
connection ; Or
6. *That there is a provision of lift in premise and the applicant has
available with the applicant.
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 categoryof 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 Cerfiticate is case of rural village
b) Agricultural Consumer
i) Certificate of Residence From Block Development Officer
 Commissioner/ Block Developlment Officer Delhi Jal Board for
i) No Objection Certificate from Development
tube wells.
temporary structure
c) Non- domestic for khokhas and
Teh Bazari Receipt Number
Structure for single delivery supply
ii No Objection Certificate for Khokha/Temporary
d) Charging station for electric vehicles specifications as may be
charging station for electric vehicles is as per the
An undertaking by the applicant that the
of Indian Standards from time to time.
specified by Central Electricity Authority or Bureau
with me and can be inspected
documents/certificates indicated at various points are available
8. The above referred applicable Licensee may disconnect the connection granted
by the Licensee at any time. In case of anyfailure to produce the same,the
produce/allow the inspection of said documents/certificates.
owing to such failure, reluctance on my part to to request of any external
9. That I will provide acopy of any of
above applicable documents to the Licensee pursuant
seeking such information.
government agency, judicial forum or any other authority
not been declared to be releasing obnoxoius hazardous/pollutant by any government agency
10. That my industry /trade has breached by running of my industry /trade or granting any
and that no oders of any court of judicail authority would be against any loss accrued by the applicant on this account.
electricity connetion to the same.The Licensee is indemnified account of
to indemnify and hold harmless, the Licensee, in case of any injury or incident an
11, The Applicant further agrees at the
shall not be liable for any mishap or incident occurring
any fault in electricity work in the premises. The Licensee premises for which the connection
quality wiring at the
premises to the applicant an account of any faulty/defective/ inferior
is being applied. and
charges at the rates set out in the Licensee's Tariff Schedule
12. To pay the electricity consumption bills and all other regularly as and when the same becomes due for
miscellaneous charges for supply as may be in force from time to time,
payment.
development (SLD) charges, if any from time to
13. To deposit the additional security deposit and additional service line cum
time based on the prevailing Orders/rules, directions and Regulations of the Commission.
of Supply/Tariff Orders and any other
14. To abide by the provision of the Electricity Act, 2003 all applicable laws, conditions
Rules or Regulations as may be notified by the Commission, as applicable from time to time.
the electricity consumption charges due/outstading along with any other charge
15. That Licensee shall be at liberty to adjust
of the agreement prior to expriy of
against the Consumer Security Deposit paid by the Applicant, in the event of termination
provisions of regulations/rules /orders/directions of the
the contracted period or in case of any contractual default as per
Commission.
amended from time to time, I shall provide
16. That as per DelhiElectricity Supply Code and Performance Standards, 2017 or as have ready access
suitable and adequate space for installation of the meter/electriclty equipments where the Licensee may
to the same.
17. Toallow clear and un-encumbered access 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. Ihave 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. Itoo 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), Ishallbe 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 the cancellation of
electricity connection and disconnection etc.
20. Allthe aboye dclaration given by the Applicant shallbe construed to an Agreement between the Licensee and the Applicant

Signaure
STNGM
Name of the Applicant AmzT
SIGNED AND DELIVERED
In presence of witness
Name of witness

*Select whichever is applcable