ਆਪਣੀ ਜਾਣਕਾਰੀ ਭਰੋ

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. 1. THE CONNECTION

1. 2. THE LAND

1. 3. REASON FOR TRANSFER

1. 4. DUES

1. 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.

1. 6. DECLARATION

VERIFICATION

DEPONENT

Signature: ______________________________
__________

ATTESTATION

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