Annexure‑5
Chhattisgarh State Power Distribution Company Limited —

Customer Care Service

Application form — Load Enhancement / Reduction

HT / EHT Service — Please strike off the option not applicable
Date:
Application Ref. No. (office use):
1 Name of the Applicant / Organization
2 Service Connection Number
3 Address of premises to which electricity is being supplied
4 In case of Load Enhancement — Existing sanctioned load (kW)
5 In case of Load Reduction — Existing sanctioned load (kW)
6 Reason(s) for Load Enhancement / Reduction
7 Details of load added / disconnected (attach list of equipments — category-wise)
a) Lighting
b) Motive Power (LOAD DETAILS ATTACHED ON ANNEX.-I)
c) Agricultural
d) Other (please specify)
8 If request for conversion of service / change in supply voltage (strike whichever not applicable)
a) LT 1‑Phase → LT 3‑Phase   |   b) LT 3‑Phase → LT 1‑Phase   |   c) LT → HT   |   d) HT → LT   |   e) HT → EHT
Date:
Place:
Baloda Bazar
Name:
........
Designation:
....
Signature of the Consumer