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    Format For Declaration

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    Devendrapratapdp
    1. The document provides a format for a declaration or notarized affidavit for obtaining a new LPG gas connection or reconnection after termination. 2. It lists the information that must be included such as the applicant's name, age, address, citizenship, date of birth, and confirmation that no other household member has an LPG or piped gas connection. 3. The applicant must provide identity and residence documents and agree to terms of use including only using the connection for domestic cooking and informing the gas company of any address changes.

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    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd

    Format For Declaration

    Uploaded by

    Devendrapratapdp
    11K views2 pages
    1. The document provides a format for a declaration or notarized affidavit for obtaining a new LPG gas connection or reconnection after termination. 2. It lists the information that must be included such as the applicant's name, age, address, citizenship, date of birth, and confirmation that no other household member has an LPG or piped gas connection. 3. The applicant must provide identity and residence documents and agree to terms of use including only using the connection for domestic cooking and informing the gas company of any address changes.

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    Format for Declaration

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    1. The document provides a format for a declaration or notarized affidavit for obtaining a new LPG gas connection or reconnection after termination. 2. It lists the information that must be included such as the applicant's name, age, address, citizenship, date of birth, and confirmation that no other household member has an LPG or piped gas connection. 3. The applicant must provide identity and residence documents and agree to terms of use including only using the connection for domestic cooking and informing the gas company of any address changes.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    11K views2 pages

    Format For Declaration

    Uploaded by

    Devendrapratapdp
    1. The document provides a format for a declaration or notarized affidavit for obtaining a new LPG gas connection or reconnection after termination. 2. It lists the information that must be included such as the applicant's name, age, address, citizenship, date of birth, and confirmation that no other household member has an LPG or piped gas connection. 3. The applicant must provide identity and residence documents and agree to terms of use including only using the connection for domestic cooking and informing the gas company of any address changes.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    Format for Declaration /Notarized Affidavit

    (To be submitted by person desirous of New LPG Connection or Connection against Termination Voucher. Ration card holder to submit this declaration on plain paper, others to submit in the form of Notarized affidavit o non-judicial stamp paper of requisite value)

    Declaration
    I DEVENDRA PRATAP Son of Shri VAGISH DUTT Age 33 Year Resident of H.No. 156, Second Floor, DDA Flats, Lado Sarai, New Delhi-110030 desire to take domestic LPG connection in my name and affirm as under:1. That I am an Indian citizen. 2. That my date of birth is 07/01/1980. 3. That neither I, nor any other member of the household (household means a family consisting of husband, wife, unmarried children and dependent parents living together in a dwelling unit having common kitchen) possess any LPG connection from PSU Oil Companies or Piped Natural Gas Connection, for domestic use. 4. That Do not have Ration Card in my name or in the name of any member of my family as defined above. 5. That I am enclosing the following documents a. Self-declaration attested by Gazetted officer as proof of residence. b. PAN Card as proof of identity 6. I confirm that the LPG connection issued to me will be used in my above-mentioned address and for domestic cooking purpose only and I shall abide by all terms governing its use. 7. That I shall not possess any other LP gas installation in same kitchen. 8. That as and when second cylinder is issued to me against this connection the same will also be used in the same kitchen and with the original installation. 9. That whenever I change my residence from present address to another, I will inform the M/s Mohanil Gas Service, Indane Distributor, Delhi. 10. That if any information/declaration given by me in this undertaking or any document submitted in support of Identity/residence proof shall be found untrue or incorrect or false, Indian Oil Corporation/ Bharat Petroleum Corporation/ Hindustan Petroleum Corporation would be within its rights to withdraw the supply of Gas/Terminate the connection/ seize the equipments/ forfeit the security deposit and that I would have no claim, whatsoever against Indian Oil Corporation / Bharat Petroleum Corporation / Hindustan Petroleum Corporation for such withdrawal / Termination/ Seizure/ forfeiture.

    I hereby declare that whatever has been stated above is true to the best of my

    knowledge, correct and nothing material has been concealed there from. Date: 15.01.2013 Place: New Delhi Signature of person giving the Declaration/Affidavit Name: Devendra Pratap

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