From No: PSD/C&R/NPC/JSR/01; Effective Date: 01/08/2022

TATA STEEL LIMITED / TATA STEEL UISL

(JAMSHEDPUR)
Application Form: New Power Connection: Low Tension (LT) Service
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New Connection Customer Relationship Office: Appl No. _____________________________
Room No -2; Grahak Seva Kendra Applcn Receipt No._____________________
Tata Steel Utilities & Infrastructure Services Limited
BP/Consumer No: _____________________
Sakchi-Bouleverd Road, Northen Town, Jamshedpur.
Status: (Accepted/Rejected/Hold/Returned)
Contact No: 0657 – 6652258 / 6652279
Email ID: [email protected] CRO: _______________ Date____________

Affix colour Passport

size photo of applicant

Affix a colour photo of the premises for which electrical connection is applied

Photo Size 14 Cm x 8 Cm

AADHAR NO.

1 Owner / Organization Name

2a Name of the Applicant
Name of Father / Husband / Director
2b
/Partner /Trustee:
3 Address:
Phone 1:
(a) Phone and email id Phone 2:
Email 1:
Email 2:
House/Holding No. Plot no:
Locality/Colony:
(b) Communication Address: Street/Road:
Thana/Area
City: JAMSHEDPUR Pin:

New Connection (LT) Application Form: Annexure-2 of JSERC’s (Supply Code) Regulation 2015 1|Page
 From No: PSD/C&R/NPC/JSR/01; Effective Date: 01/08/2022
TATA STEEL LIMITED / TATA STEEL UISL
(JAMSHEDPUR)
Application Form: New Power Connection: Low Tension (LT) Service
-----------------------------------------------------------------------------------------------------------------------

Same as Above:
House / Holding no. Plot No.
Locality/Colony:
(c) Connection Address
Street/Road:
Thana/Area:
City: JAMSHEDPUR Pin:

(d) (Landmarks to identify the location)

(e) Establishment No (if any):

Do you have water connection from
(f) B.P. /Consumer No:
Tata Steel UISL? If yes, provide
4 Plot size: …………………sq. feet Covered area: ………………sq. feet
Domestic Commercial
5 Category of Supply:
Industrial Agriculture / Others
6 Purpose of Supply:
7 Total Load applied for: ____________kW/kVA Voltage: 400 V / 230 V
8 Type of Supply Permanent Temporary
8a If Temporary, Specify period From _______________ To ________________
Details of Existing Connection (in Case of Switchover/Changeover supply from other utilities to
9
Tata Steel) and enclosed a copy of latest bill from existing utilities.
Consumer No: Consumer Name:
Supply Circle: Name of Utilities
Please indicate whether you want to carry out the works of laying service line and/or
(Yes / No)
10 dedicated distribution facility for the electricity supply requisitioned
11 Please indicate whether you want to install your own CEA approved meter (Yes / No)
12 List of documents to be enclosed with application:
If applicant is a person (any of the following)
a) Aadhaar Card
b) Voter ID Card
(a) Proof of Identity of the applicants c) Passport
d) Driving License
e) Photo Ration Card or Photo Identity card issued by Govt. Agency.
Please submit any of the following documents (any of the following)
a) Copy of Registered Sale / lease / Partition deed or Mutation paper /
copy of khasra / khatauni / khata-nakal (Agricultural connections)
Proof of ownership or occupancy b) Registered General Power of Attorney;
(b) of premises for which electricity c) Municipal tax receipt or Demand notice or other related document;
connection is required d) Letter of allotment.
e) An applicant who is not an owner, but an occupier of the premises
shall along with any one of the documents listed at (a) to (d) above
also furnish a “No Objection Certificate” from owner of the premises.

New Connection (LT) Application Form: Annexure-2 of JSERC’s (Supply Code) Regulation 2015 2|Page
 From No: PSD/C&R/NPC/JSR/01; Effective Date: 01/08/2022
TATA STEEL LIMITED / TATA STEEL UISL
(JAMSHEDPUR)
Application Form: New Power Connection: Low Tension (LT) Service
-----------------------------------------------------------------------------------------------------------------------
In case of a proprietary firm, an affidavit stating that the applicant is the
sole proprietor of the firm / In case of partnership firm, partnership deed
(c) For Organization /Company: / In case of Limited Company, Memorandum and Articles of Association
and Certificate of Incorporation along with Resolution for authorised
signatory wherever applicable.
No Objection Certificate for khokha or temporary structure from the nagar
Non-Domestic Khokhas and nigam / nagar palika / nagar panchayat / gram sabha / gram panchayat /
(d)
Temporary Structure: land development authority / land owning agency.
Temporary connection in public Permission from District Commissioner / Commissioner of Police and
(e) Intimation to Chief Electrical Inspector.
gathering more than 100 People:
(f) PAN No. (please enclose a copy)
(g) Any other document as applicable (Please specify):
Any electricity dues outstanding in licensee’s area of operation in consumer’s
13 Yes/ No
name:
14 Any electricity dues outstanding for the premises for which connection applied for: Yes/ No
Any electricity dues outstanding with the Distribution Licensee against any firm
with which the consumer is associated as an Owner, Partner, Director/Managing Yes/ No
15 Director:
(For columns 13, 14 & 15 if the answer is ‘Yes’ in any case please provide details on a separate sheet)

I/ We hereby declare that,

a) The information provided in this application is true to my knowledge

b) I/We have read the Electricity Supply Code and agree to abide by the conditions mentioned therein.
c) I/We will deposit electricity dues, every month, as per the applicable electricity tariff and other charges.
d) I/We will own the responsibility of security and safety of the meter, cut-out and the installation hereafter.

Date: _______________________ Signature of the consumer/Authorized Signatory

Place: _______________________ Name:_________________________________

Disclosure Statement:
Your information such as Name, Contact number, Connection Address and Consumer no. of existing connection (if any) may be
shared with Jharkhand Bijli Vitaran Nigam Limited (JBVNL) to get the information relating to any pendency / dispute / cases etc.
on the part of that you with JBVNL as per notification no. 66 dated 21. 02. 2019 (Operation of Parallel Licensees’ Regulation'
2019) by Hon'ble Jharkhand State Electricity Regulatory Commission and you have your consent of the same.
.
Signature of Applicant as acceptance of above____________________

New Connection (LT) Application Form: Annexure-2 of JSERC’s (Supply Code) Regulation 2015 3|Page
 From No: PSD/C&R/NPC/JSR/01; Effective Date: 01/08/2022
TATA STEEL LIMITED / TATA STEEL UISL
(JAMSHEDPUR)
Application Form: New Power Connection: Low Tension (LT) Service
-----------------------------------------------------------------------------------------------------------------------
WIRING CERTIFICATE CUM LOAD VERIFICATION
To
Tata Steel Ltd / Tata Steel UISL,
Certificate No._______________
Date: _____________________

We, ____________________________________, Licensed Electrical Contractor, having register office

at __________________________________________________________, hereby certify that, electrical
wiring of House
No_____________________________________________________________________
___________________________________________, (complete address) has been carried out / tested
by us accordance with the provision in Indian Electricity Act and same has been found to be safe for
energization with electricity supply. Load verification details and test results are given below.

Load Verification Details

Test Result
Apparatus No. of Point Wattage Total Wattage
Bulbs
CFL We certify that,
LED 1) Insulation resistance wiring of
LED Bulbs above house / premises /shop /
office has been tested by us with
Tube /LED Tube
insulation resistance tester, and
Fans / Exhaust Fan resistance value found to be
Geysers Main Circuit __________Ohm
Oven/Microwave Sub Circuit ___________Ohm
Air Conditioner
Refrigerator 2) Soil Resistivity of Earthing station
Television (TV) for above house / premises /shop /
Plug (5 Amps) office has been tested by us with
Plug (10 Amps) Earth tester, and resistance value
found to be
Plug (15 Amps)
Earthing Pit-1: _______ Ohm
Lift
Earthing Pit-2: _______Ohm
Water Pump
Combine Value: _______Ohm
Others (Specify A)
Others (Specify B) Date of Test_____________
Total Connected Load in kW
Total Load Applied in kW (Round Figures)
Contractor’s Detail:
1. Name: ________________________________

2. License No.: ___________________________

3. Contact No.: ___________________________ Contractor Signature with Seal

New Connection (LT) Application Form: Annexure-2 of JSERC’s (Supply Code) Regulation 2015 4|Page
 Declaration / Undertaking

I, ____________________________________ Son/Daughter/Wife of ___________________________ Resident of

_______________________________________________ (hereinafter referred to as “Applicant”, which term shall
mean and include executors, administrators, heirs, successors and assigns), do hereby swear and declare as under:

Or

The _______________________________, a company incorporated under the provisions of the Companies Act, 1956
having its registered office at ________________________________________________________ (hereinafter
referred to as “Applicant”, which expression shall, unless repugnant to the context or meaning thereof, include its
successors and assigns), do hereby swear and declare as under:

THAT the Applicant is an occupant of the premises at ___________________________________________________

in support of which the Applicant has enclosed copy of ________________________________as proof of occupancy.

THAT the Applicant has requested the Tata Steel Limited (TSL) as Distribution Licensee to provide an Electrical
connection at the above-mentioned premises in the Applicants name for the purpose mentioned in the application
form.

THAT Applicant undertakes that mere supply of electricity shall not be the ground of any claim of right, title or interest
of land or building or premises against Tata Steel Limited /Tata Steel Utilities and Infrastructure Services Limited (Tata
Steel UISL) or any other person including but not limited to family member(s) and applicant should not raise any dispute
in this regard. The electricity connection shall have no bearing on the right, title or interest of the Applicant
corresponding to the land or building or premises and the Applicant shall only be considered as a consumer of
electricity.

THAT the electricity connection which will be installed in the name of the Applicant shall be subject to the final outcome
of any case or title suit or litigation pending before any court or forum involving the Applicant and any document
received from TSL/Tata Steel UISL by the Applicant in respect of new electricity connection shall not be used by the
Applicant as an evidence to prove his/her title to the premises.

THAT in furnishing the Declaration, the Applicant has clearly understood that should the above statements prove to
be false or incorrect at any later stage, Tata Steel Limited / Tata Steel UISL shall have every right to disconnect supply
of electricity of the Applicant without any notice and adjust dues against Consumer Security Deposit, if any.

THAT the Applicant hereby agrees and undertakes:

1. To indemnify Tata Steel Limited/Tata Steel Utilities and Infrastructure Services Limited against all proceedings,
claims, demands, costs, damages, expenses that the licensee may incur by reason of a fresh service
connection given to the Applicant.

2. That all Electrical Works done within the premises are as per Central Electricity Authority (Measures relating
to Safety and Electricity Supply) Regulations, 2010 and have been carried out by a licensed electrical
contractor (in case the Applicant is an owner and wiring in the premises is new)

Or

Declaration / Undertaking: Annexure-3 of JSERC’s (Supply code) Regulation 2015 5|Page

 That all Electrical Work done within the premises are as per Central Electricity Authority (Measures relating to
Safety and Electricity Supply) Regulations, 2010 to the best of our knowledge (where application is for
reconnection or Applicant is occupier of the premises)

3. Tata Steel Limited/Tata Steel Utilities and Infrastructure Services Limited is indemnified against any loss
accrued to the applicant on this account. Further, Applicant agrees that if there is any harm/loss to the property
of the Tata Steel as Distribution Licensee due to the fault in Electrical work within the premises of Applicant,
all the liabilities shall be borne by the Applicant.

4. To pay the electricity consumption bills and all other charges at the rates set out in Tata Steel Limited as
Distribution Licensee’s Tariff Schedule and miscellaneous charges for supply as may be in force from time to
time, regularly as and when the same becomes due for payment.

5. To deposit the additional consumption deposit as revised by Tata Steel Limited/Tata Steel Utilities and
Infrastructure Services Limited from time to time based on the consumption of the Applicant in preceding year.

6. To abide by the provisions of the Electricity Act, 2003 and its amendment up to date, JSERC’s latest Electricity
Supply Code Regulation, Tariff Orders and any other rules or regulations notified by the Commission, as
applicable from time to time.

7. Tata Steel Limited/Tata Steel Utilities and Infrastructure Services Limited shall be at liberty to adjust the
electricity consumption charges along with any other charges against the Consumer Security Deposit paid by
the Applicant, in the event of termination of the agreement prior to expiry of the contracted period or in case of
nay contractual default.

8. To be responsible for safe custody of Meters, CTs, Cables etc. provided by Tata Steel Limited or Tata Steel
Utilities and Infrastructure Services Limited as Distribution Licensee and in case, there is any damage to
equipment due to the reasons attributable to Applicant the same shall be chargeable to the Applicant. Further,
all repercussions on account of breakage of seals of meters etc. or Direct/Dishonest Abstraction of energy
shall be to the account of Applicant, as per the existing laws.

9. To allow clear and unrestricted access to the meters for the purpose of meter reading and its checking etc.

10. That the Applicant would let Tata Steel Limited or Tata Steel Utilities and Infrastructure Services Limited
disconnect the Service connection under reference, in the event of any default, non-compliance of statutory
provisions and in the event of a legally binding directive by Statutory Authority(ies) to affect such an order.
This shall be without prejudice to any other rights of Tata Steel Limited or Tata Steel Utilities and Infrastructure
Services Limited including that of getting its payment as on the date of disconnection.

11. That Tata Steel Limited or Tata Steel Utilities and Infrastructure Services Limited shall not be held responsible
for any interruption or diminution of supply of Electricity.

12. All the above declaration given by the Applicant shall be construed to an Agreement between the Applicant
and Tata Steel Limited/Tata Steel Utilities and Infrastructure Services Limited.

Signature of the Applicant

Name of the applicant

SIGNED AND DELIVERED

In presence of witness Name of Witness

Note: Declaration/undertaking to be typed or printed on Rs 5 or above Non-Judicial stamp paper and to be Notarized

Declaration / Undertaking: Annexure-3 of JSERC’s (Supply code) Regulation 2015 6|Page