Official :: Vidyut Suraksha Nideshalay

Annexure Form / 18

Application for obtaining Electrical Contractors License

1-(A) Name of applicant: .......................................................................................................................................................... (in plain letters)

(B) Age of applicant: .......................................................................................................................................................... (in plain letters)

2- Father's Name: ...............................................................................................................................................................

3- Full house address: .............................................................................................................................................................................

4- Full address of the shop: ...................................................................................................................................................

5- The applicant firm for which to obtain license is : ............................................. ....................................................................................................................

6- Name of partners, age of each and father's name and full address : .............................................................................................................................

(1) ........................................

(2) ........................................

(3) ........................................

(4) ........................................

7- Relationship to the shopper ........................................................................................................................

8- If the applicant or the names of the partners or the electrical license before, before the name of the firm, give the details and tell them that the license is currently in force or canceled. If canceled, tell the reason for cancellation ........................................

9- Name of the person who is the Electrical Supervisor in the job of the applicant, Certificate Number and the validity period of the certificate (Appointment / Appointment Letter) --------------------- -------------------------------------------------- -------------- Duration (attach appointment / acceptance letter)........................................................................................................................

10- Name of the wireman in the job of the applicant, permit number of each and every permit recognized - duration (enclose appointment / acceptance)

(1) ........................................

(2) ........................................

11- Estimated value of electrical stock held by the applicant or shop normally ................................................................................

12- Full details of applicants in the examination (attach the shadow copy of cashmeam)

(1) ........................................

(2) ........................................

(3) ........................................

(4) ........................................

13- Number and date of Treasury invoice by which payment of 900 / - rupees for the inspection and license of the shop was paid. (Total invoice sent along with the application) .....................................................

14- Category of license which the applicant wishes to receive ........................................("A", "B" or "C") I / We ........................................ I hereby declare that the above All information is completely true in my / our information and I / we have not given any wrong information knowingly. I / We have studied all the rules of Government Releases No. 1135-E / L / 22P0B0-96-EL050-58 dated May 11, 1967. Under which the application for this license has been presented and I / we assure that I will comply with all the rules.

Signature of applicants and partners
(1) ........................................ (2) ........................................

Including seal
(1) ........................................ (2) ........................................

Note -:

(1) If any wrong information is found on light, then the license will be canceled.

(2) The amount deposited in accordance with the notes under section 10 can not be returned.

(3) Accounting titles "0043-Electricity tax and fees" to deposit fee.

"102 - Fees under Indian Electricity Rules"