11/25/22, 4:08 PM SV/TV/CTA FORM

HINDUSTAN PETROLEUM CORPORATION LIMITED UNIQUE CONSUMER ID: 1131249400000685

(A GOVERNMENT OF INDIA ENTERPRISE)

ID CODE DOCUMENT TYPE
REGISTERED OFFICE: 17 ,JAMSHEDJI TATA ROAD
2 Termination Voucher
MUMBAI- 400 020

DOC NO DATE FILLING PLANT NAME PLANT CODE

2000648 25/11/2022 MANERI LPG PLANT 12504
CONUSMER NO. DEALER CODE DEALER’S NAME AND ADDRESS
600694 12508410 SAHU HPGAS GRAMIN VITRAK
GADASARAI GADASARAI DINDORI
GADASARAI,MADHYA PRADESH 481882
CONNECTION REGISTRATION EQUIPMENT CODE NOS AMOUNT
TYPE | NATURE NO 501 CYLINDER 036 2 2900.00
6 | 1 DATE 13/05/2013 REGULATOR 047 1 150.00
AMOUNT IN WORDS Rupees three thousand fifty only TOTAL 3050.00
CONSUMER NAME NESTOR TIRKI
CONSUMER ADDRESS S/O PAULUM TIRKI SAGAR TOLA
SAGARTOLA
GADASARAI,MADHYA PRADESH 481882

OLD PARTICULARS DOCUMENT NO. DATE

DEALER CODE 12508410 ORIGINAL SV 1000698 12/09/2013
FILLING PLANT CODE 12504 CURRENT SV 1000698 12/09/2013
CONSUMER NO. 600694 ADDL. SV
OIL COMPANY TV/CTA/SVCD 2000648
1. Hindustan Petroleum Corporation Limited (hereinafter called “the corporation) loans to the consumer and the consumer takes on loan from the corporation, cylinders and pressure regulators (hereinafter collectively
called “the equipment”) required for the supply of the corporation’s product viz. “HP gas” (hereinafter called the “gas”).
2. The consumer shall deposit with the corporation an amount in accordance with the corporation’s tariff in force from time to time as security for the due fulfilment by the consumer of his obligations hereunder. The
corporation shall be under no obligation with regard to the manner of use or disposal of the funds received as deposit from the consumer nor shall it pay to the consumer any interest thereon.
3. The consumer shall remain responsible to the corporation for the safe custody of the equipment and shall not sell, mortgage or otherwise dispose of the equipment or create any interest therein or charge thereon in
favour of any party.
4. The consumer shall not remove the equipment to any address other than that shown on the obverse thereof without obtaining the prior written permission of the corporation’s dealer concerned (hereinafter called
“the dealer”). Further, in the event of the consumer’s departure from the area serviced by the dealer, he shall return the equipment to the dealer.
5. The consumer shall not attempt to repair the equipment or cause or permit anyone other than the corporation to do the same and shall permit the dealer to remove the equipment for repairs from the consumer’s
premises. The consumer shall not exchange the equipment with or have the cylinder refilled by anyone other than the corporation or the dealer, not shall use the cylinder for any purpose other than as a container for
the gas supplied by the corporation.
6. The consumer shall be liable for any loss of or damage to the equipment or any part thereof and shall reimburse to the corporation the value of the missing or damaged equipment or part thereof in accordance with
the corporation’s tariff in force on the date of reimbursement.
7. The corporation and/or the dealer shall not be responsible for any failure and/or delay in supplying the gas to the consumer if such supply has been delayed/hindered or prevented by any circumstances whatsoever
be the control of the corporation and/or the dealer.
8. Any sale by the dealer to the consumer of the gas appliances and their parts and accessories including rubber tubing/ suraksha hose used for connecting the appliances to the equipment shall be effected by the
dealer on his own account and in his own right.
9. The consumer shall use only appliances of a type approved by the ISI or the corporation.
10. All necessary installation work including the connection/disconnection of cylinder to/from the appliances and/or pressure regulator and the work of repairs to appliances and the replacement of rubber tubing will
be carried out at the consumer’s expense and on his own responsibility by the dealer and not on behalf of corporation. The fact that the consumer is supplied “HP gas” shall not be deemed to impose any liability on the
corporation with regard to the fitness or otherwise of the installation and/or repair work. The corporation and/or the dealer and/ or the person authorised by either or them shall, however, have the right to inspect the
installation at any time and, if considered necessary, for reasons of safety, to refuse to supply the gas to the consumer.
11. The corporation shall not be liable for any loss or damage caused to any person or property as a result of the installation and/or the use of the gas by the consumer. In the event of any accident involving the
consumer’s installation, he shall forthwith inform the dealer.
12. The corporation as well as the consumer shall be at liberty to terminate the contract at any time by giving 15 days’, notice in writing. On termination of this contract the consumer shall forthwith return the
equipment to the corporation and/or the dealer, thereafter refund the balance of the deposit made by the consumer with the corporation after deducting therefore such amounts, if any, as may be due to the
corporation.
13. As per the gazette of India notification dated 10th September, 2009 on LPG control order, 2000 a “household” means a family consisting of husband, wife, unmarried children and dependent parents living together
in a dwelling unit having common kitchen can have one LPG connection in their “household” and in case if such family is having or avails a piped natural gas connection of any company then the LPG connection will be
surrendered within 60 days failing which HPCL will cancel the LPG connectionor the Refills can be taken at Non Subsidised rates.
14. The consumer shall pay the stamp duty, if any, in respect of the subscription voucher.
For subscription voucher only
(deposit will not be refunded without production of this document)

HP gas consumer certificate: i/we acknowledge having received from HPCL the quantity of HP gas cylinder(s) and pressure regulator(s) mentioned in the nos. Column hereof on loan on the conditions which have been
set out overleaf and by which i/we agree to abide. I/we have also received the HP gas instruction card.
HP gas distributor’s certificate: received on behalf of Hindustan petroleum corporation ltd., the amount mentioned above being the deposit of HP gas cylinder(s) and pressure regulator(s) loan in accordance with
company’s tariff
For termination voucher only
HP gas consumer’s certificate: I/we declare that i/we have received the amount as mentioned above being the balance of the amount of deposit to my/our credit in accordance with the conductors of supply. HP gas
distributor’s certificate: equipment received in good condition. This TV is valid for one year
REMARKS: Regulator Serial No. :B302964. Quota consumed for FY 2022-2023:2/12,Impressed Fund Amt.Collected Rs 568.00,Transfer to : BILASPUR

DATE DEALER’S SIGNATURE TO BE SIGNED IN PRESENCE OF EACH OTHER DATE CONSUMER SIGNATURE

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