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    FormA 9-6-2

    Uploaded by

    zzirhan
    By signing the application, the applicant declares that the information provided is accurate. They agree to TNB's terms and conditions of supply and consent to TNB collecting

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    FormA 9-6-2

    Uploaded by

    zzirhan
    26 views1 page
    By signing the application, the applicant declares that the information provided is accurate. They agree to TNB's terms and conditions of supply and consent to TNB collecting

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    By signing the application, the applicant declares that the information provided is accurate. They agree to TNB's terms and conditions of supply and consent to TNB collecting

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    26 views1 page

    FormA 9-6-2

    Uploaded by

    zzirhan
    By signing the application, the applicant declares that the information provided is accurate. They agree to TNB's terms and conditions of supply and consent to TNB collecting

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    For Office Use :

    APPLICATION FOR ELECTRICITY SUPPLY CA No.:


    SR No.:

    Please note that only submitted application with complete and correct information will be processed.

    PART 1 : TO BE COMPLETED BY APPLICANT

    For Application Under Individual Name :


    Name of Applicant : NG HUAN NEE MyKad / Pasport : 761117-07-5097
    (Mr/Mrs/Ms) MR.
    ("the Consumer")

    Mother's Name : Date of Birth : 17-Nov-1976


    (For Security Verification) (Below 18 years is not entitled to apply)

    Next Of Kin : Next of Kin Phone No :


    (The person as an alternative to be contacted if we are unable to reach you)

    Home/Office No. : Fax No. :

    Mobile No. : 0164461188 Email : hnng6138@gmail.com

    Communication Options: Letters Email Both

    Billing Delivery Options: Byhand Post Email


    (Please select one (1))

    Details of Premises
    a. Address of Premises : M TREE HILL, 9-6-2, LORONG SUNGAI BATU 3A, SUNGAI BATU, 11920 PULAU PINANG, PULAU PINANG
    (where supply is required)

    ("the Premises")

    b. Premises Ownership Owned Rented

    c. Premises Type : Residential Use - Residence description : Residence: Apt/Condominium (> 3 rooms)
    (This activity will determine the (For example, Two storey terrace)
    appropriate tariff)

    Non-Residential Use Commercial Manufacturing Agriculture

    Mining Streetlight

    Main activity at premise:


    (For examples: Bakery Shop, Sawmill, etc.)

    d. Correspondence Address : M TREE HILL, 9-6-2, LORONG SUNGAI BATU 3A, SUNGAI BATU, 11920 PULAU PINANG, PULAU PINANG
    (If different from premises address above)

    e. Supply required date : 20-Jul-2023 (Electricity supply by TNB is subject to consumers’ site readiness)

    TYPE OF APPLICATION * Please select ( / )

    New Electricity Supply (Permanent) Temporary Electricity Supply

    Additional Electricity Supply Estimated Supply End Date :

    Change of Tariff (Do not fill section 2)


    Others : Supply Application - Group Move In

    APPLICANT'S DECLARATION
    1. I / We hereby attest that the contractor appointed by me / us / the housing developer as stated herein is a contractor registered with Energy Commission. I / We also give permission to the contractor
    to do all necessary works related to my / our application.
    2. I / We hereby attest that the electrical wiring is in a good condition.
    3. I understand and agree that as the registered consumer for electricity at the said premise I will be liable for any electricity consumed during the tenancy and/or occupancy period including any loss or
    damage suffered by TNB as permitted under the Electricity Supply Act.
    4. I agree to ensure the meter, TNB’s installation and/or equipment at the said premises is not tempered at any time during the tenancy or occupancy period except with a written approval from TNB.
    5. I / We hereby acknowledge that all information given are true and accurate and TNB shall have the right to take any necessary action if the information given are false or inaccurate.
    6. I / We agree to all the Terms and Conditions of Supply as attached herein ("The Terms and Conditions of Supply for Consumer")and it shall become part of a binding
    7. I / We as the signatory below do hereby consent to TNB, its agents and / or its permitted assigns for collecting, recording, holding or storing my / our personal data in accordance to Personal Data
    Protection Act 2010 for a lawful purpose or necessary for any matters related to electricity supply by TNB.
    8. I / We acknowledge that the telephone number / mailing address / e‐mail address provided is true and accurate and TNB will be notified if there is any change in the information. My / our failure to
    update the telephone number / mailing address / e‐mail address will not cause the TNB to be liable for any failure to deliver the notices under this Contract.

    Name of Applicant:
    Applicant's Signature / Company Stamp (signing for the company)
    (whichever applicable) Designation :
    Date : MyKad No :

    Page1/1

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