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New Connection Request
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New Connection Request
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A-1 Application Form
Service Request ID [
]
Instructions for filling the form:
Kindly fill complete and correct information in relevant column.
Applicant will be solely responsible for incomplete or incorrect information
Applicant is requested to note the request id for future tracking of the application.
Please provide the correct nearest consumer number, so that your request can be assigned to proper MSEDCL field office.
The applicant will be contacted by MSEDCL officer /Call Center Representative on email/mobile provided by you for verification.
Please download
New Connection Form
and keep ready duly filled in and signed with required documents (which are mentioned on A1 Form).
Click
here
for help regarding filling New Connection Request.
Email address is mandatory and either Phone number or Mobile number is mandatory.
General Information
Individual
Consumer Category:
*
-- Select --
1-LT-SUPPLY
2-HT-SUPPLY
3-EHV
Others:
Supply Type:
*
-- Select --
SINGLE-SINGLE PHASE
THREE-THREE PHASE
HT-HT SUPPLY
Service Requested:
*
-- Select --
001-New Connection (Permanent)
002-New Connection (Temporary)
Application Date:
Application Details
Applicant/Company Name:
*
-- Select --
Mr
Mrs
Ms
M/S
Occupation:
*
-- Select --
SERVICE
PROFESSION/BUSINESS
OTHERS
Address at which supply is required(Please enter complete details)
Plot/ Flat No/ Survey No / House No / Building Name:
*
Address Line1:
*
Landmark:
City/Village:
*
PinCode:
*
Email:
*
Mobile:
Phone:
Existing/ Nearest Consumer No:
*
Billing Details
Click here if billing Address same as Meter Address
Plot/ Flat No/ Survey No / House No / Building Name:
*
Address Line1:
*
Landmark:
City/Village:
*
PinCode:
*
Email:
*
Mobile:
Phone:
Type Of Premises:
*
-- Select --
1-OWNED
2-RENTED
3-LEASE
4-LIS/OTHERS
Others:
To be filled if Type Of Premises selected is OTHERS.
Consumer Sub Category:
*
-- Select --
30-PWW
40-Residential
50-Commercial
60-LT industrial
70-LT powerloom
80-Street Light
90-Agriculture
91-LT poultry
92-LT Advertisement and Hoarding
93-LT Precooling
94-LT temporary Religious
95-LT temporary others
165-Temp-Construction
166-Crematorium And Burial
167-Public Services
Others:
Requested Load / Contract Demand
Requested Load:
*
KW
HP
Contract Demand:
*
KVA
Extension/ Reduction
For Extension/ Reduction of Load :
Existing Load:
*
KW
HP
Revised Load:
*
KW
HP
Extension/ Reduction
For Change in Contract Demand :
Existing Contract Demand:
*
1 - KVA
Total Contract Demand
*
1 - KVA
I/we make the following declaration;
to abide by the provisions of the Electricity Act 2003 and Maharashtra Electricity Regulatory Commission Electricity Supply Code and other conditions of Supply.
to pay for the supply of electricity based on the prevailing tariff rates of MSEDCL
to pay for all other proper charges as become due in accordance with above regulation and approved schedule of charges of MSEDCL.
to deposit such security as MSEDCL may be entitled to be required from me/us under the above Act and Regulations.
to undertake to avail supply within one month from the date the MSEDCL intimate that it is ready to supply to our premises failing which I/we undertake to pay the MSEDCL the minimum charges as may be applicable.
The above information is true and if any false information is observed, I will be fully responsible for the same.
In the event of death of individual I/We hereby nominate to receive or adjust the deposit outstanding in my/ our name to
I/ we agree to the terms and conditions
Place:
*
Submit
