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Acknowledgement

Registration No NR90422678344

Registration Date 27/06/2022

Applicant Name Sarala

Category DOMESTIC

Contract Load 1000 Watts

Application Fee 25

GST on Application Fee 4.5

Development Charges 1200

GST on Development Charges 216

Security Deposit 200

Total 1645.5

Undertaking:
I. I/We agree that TSSPDCL assume no liability whatsoever for any monetary or other damage suffered by me/us on account of: (i) the delay,
failure, interruption, or corruption of any data or other information transmitted in connection with use of the Payment Gateway or Services in
connection thereto; and/ or (ii) any interruption or errors in the operation of the Payment Gateway.
II. I/We undertake and agree that No claims for refund/transfer shall be made and in the event such claim is made it shall not be entertained.
III. I/We undertake that I am / We are the statutorily bonafide owner for the premises for which new service connection is applied for and agree
to pay the Tariff and Miscellaneous charges, prescribed by the Company and to abide by the General Terms and Conditions of Supply notified by
the Company from time to time, which shall govern the supply of electricity to me/us in all respects.
IV. I/We undertake that all the required documents such as Ownership deed,NOC,EC and necessary certificates/approvals will be submitted at
the time of fixing of meter (or) as and when demanded by the TSSPDCL.
V. I/We shall undertake to execute an Agreement in the prescribed form, if so called upon by the Company. Whether such an Agreement is
executed or not, this acknowledgement itself shall oblige me/us to confirmed abide by the General Terms and Conditions of Supply notified by the
Company from time to time.
VI. I/We certify that I have no dues to the Company either here or anywhere.
VII. I/We certify that there is no case of Theft of Electricity/Unauthorized use of Electricity, pending against me.
VIII. I/We undertake that if the number of services in the same premises/compound is above four, I will apply for the panel board.
IX. I/We undertake and agree for recovery from the excess paid amounts, if any against services found to be under disconnection or services
with or Unauthorized use of Electricity cases or Theft of Electricity cases found, and also against services clubbed for being in the same
premises.
X. I/We undertake to provide suitable arrangements for "way leave" at my/our own cost.
XI. I/We request to company to provide meter for measuring the electricity supplied to me/us. I/We will pay the monthly meter rentals, as may be
fixed by the Commission from the time to time.
XII. I/We undertake that perfect earthing is done as advised by the TSSPDCL.
XIII. I/ We undertake that Meter can be installed outside the house/ Verandah in the Ground Floor and I/We shall provide the visible service wiring
upto the metering point without concealed wiring.
XIV. I/ We undertake to pay the required amounts, if any extension of LT/HT network is required. Further, I/We will take up the work .
Through Department On Turnkey
XV. I/We authorize TSSPDCL to provide information about the progress of application through SMS to my cell phone from time to time.
XVI. I/ We undertake that transaction with TSSPDCL will not be entitled for Input Tax Credit if GSTIN No. is not furnished and any correction for
GSTIN will not be allowed.
XVII. I/We undertake and agree that Refund of amount for any Wrong/Duplicate/Double/Excess/Any other transation credited to TSSPDCL will
be done as per Department Rules in vogue.
Note:- In case of any queries please mail to aeicsc_charminar@tssouthernpower.com.

Signature of Applicant Signature of Original Owner (in case of title transfer)

Place Date

Signed by the applicant in my presence:

Witness 1 Witness 2

Signature Signature

Name and Address Name and Address

Date: Date:

(For Office purpose only)

RECORD OF THE APPLICATION
1. Sent to AE/Operation on ________________________
2. Work allocated to ______________________________
a) Separate portion Yes/No
 b) No OSL/UDC/TE/UUE/BB premises Yes/No
c) Connected load is same as declared Yes/No
d) Whether Service wire is Concealed Yes/No
e) HT & LT Clearances maintained Yes/No
f) Whether any Overhead lines are passing over the house/Premises Yes/No
g) T/F Code /Feeder Code
h) T.C. Seal No: P.P.Box Seal No.
Impression:
1. Received from the Designated Officer along with Test Report on ________________________
2. SC. No.______________________________

ACKNOWLEDGEMENT OF APPLICATION AND INTIMATION OF PAYMENT DETAILS

Designated Office Date of Submission of
Application /Registration
Registration No. Signature of the Receiving
Officer with Stamp
Total Payment Received

Signature of __________________

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