ELECTRICITY CONNECTION TRANSFER AFFIDAVIT
Executed at __________ on __________.
I, __________, __________, resident of __________, holding __________, ordinarily resident within __________ (the "Deponent" or "I"), do hereby solemnly affirm and declare as follows:
- THE CONNECTION
1.1 This affidavit concerns the __________ electricity connection bearing account number __________ with __________, standing at present in the name of __________, for the premises at __________.
- REASON FOR TRANSFER
2.1 I seek transfer of this connection into my name because of __________.
2.4 My relationship to __________ is: __________.
- DUES
3.1 __________.
3.2 I undertake to clear any dues found outstanding against this connection up to the date of transfer, and I indemnify __________ against any claim, loss or demand arising from a due, a defect in my title to succeed to or acquire the connection, or a statement in this affidavit that later proves incorrect.
- SAFETY UNDERTAKING
4.1 I undertake to use the connection only at the premises stated above, for the category of use stated above, and to comply with the distribution office's safety and inspection requirements. I confirm that the internal wiring, meter board and earthing at the premises have been checked and are safe.
- DECLARATION
5.1 Every statement made above is true to my own knowledge and belief, and I have concealed nothing material to this transfer. I am aware that furnishing false information to obtain a transfer is an offence, and that __________ may refuse or cancel the transfer if any statement made here is found false.
VERIFICATION
Verified at __________ on __________ that the contents of paragraphs 1 to 5 above are true and correct to my own knowledge, that no part of it is false, and that nothing material has been concealed.
DEPONENT
Signature: ______________________________
__________
ATTESTATION
Solemnly affirmed and signed before me on __________ at __________, the Deponent having been identified to my satisfaction by __________.
Notary Public / Oath Commissioner
Registration No. and seal: ____________________