Fill in Tubewell / Motor (AP) Electricity Connection Transfer Affidavit (PSPCL)

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Tubewell / Motor (AP) Electricity Connection Transfer Affidavit (PSPCL)

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TUBEWELL / MOTOR (AGRICULTURAL POWER) ELECTRICITY CONNECTION TRANSFER AFFIDAVIT

I, __________, __________, resident of __________, holding __________, ordinarily resident within __________ (the "Deponent" or "I"), do hereby solemnly affirm and declare as follows:

1. THE CONNECTION

2. THE LAND

3. REASON FOR TRANSFER

4. DUES

5. SAFETY AND CORRECT-USE UNDERTAKING

5.1 I undertake to use the connection only for irrigating the land described above, at the sanctioned load stated, and to comply with the distribution office's safety and inspection requirements. I confirm that the motor, starter and connected wiring have been checked and are safe.

6. DECLARATION

VERIFICATION

DEPONENT

Signature: ______________________________
__________

ATTESTATION

Notary Public / Oath Commissioner
Registration No. and seal: ____________________

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