FORM-1 (Free of Cost)

Connected Load Registration No.& Date

(in kW)
Date of Connection--
Tariff
Purpose

ELECTRI
CITY

Application for New Service Connection/Load Enhancement/Load Reduction/Reconnection/ Change of

Name/Shifting/Temporary Supply/Conversion of Service/Change of Consumer Category

(For LT Domestic, General purpose & PI consumers)

1
Re-effecting Service
Please Tick ( ) New Service Connection Temporary Service

Others (Specify)
Revising Connected Load Ownership Change
2
Name of Electric Section
Name of the Sub-Division
3 Name of the applicant/ Consumer Con. No.(If existing consumer)
4
5 e-mail:
6 7 Location Details
Address of Premises (where supply is required) Plot No.-
Street-
Area/ Sahi/
Sector
Village/ Town/
City
P.S.
Mobile No:-
8 Permanent Address (with Land phone no, if any) 9. Address for communication with Land phone no, if any)
(If different, where supply is required)

Pin: Mob: Pin: Mob:

10 Nearest Electric Pole No. 11 Nearest Cons. No.
12 Purpose of availing Service Connection Dom GPS PI Others
13 Single Phase/3Phase 14 Total connected Load ……………………….KW

Yes / No 16. Distance (in meter) from nearest Pole to Meter Box
15 Whether Phase Addition / OH line / Pole is required
for effecting Service Connection
Not Known
Status of applicant
17 Owner If tenant, whether
18 consent of owner is YES / NO
/
Tenant obtained?
(Strike out whichever is not applicable)
 19 I/We hereby request you to supply Electrical energy to the premises hereinafter described. I/ We am/are the owner/lawful occupier of the premises
at Sl. No.-6 In which supply of electrical energy is now required.
20 I / We agree to take supply for TWO YEARS to utilize the energy for General purpose/ Domestic purpose/PI only. Thereafter Agreement shall so
continue unless terminated by either of the parties after giving one month's notice.
21 I/ We agree to pay for the service connection and other dues including the security as may be payable and shall also pay the charges, surcharges,
electricity duty in accordance with the OERC Distribution (Conditions of Supply) Code, 2019 provided that annual sum payable individually by me/
us under the provision of Section 45 of the electricity Act, 2003 shall not be deemed to be part of the minimum monthly charges. if any, payable
under OERC Distribution (Conditions of Supply) Code,2019.

22 I / We have obtained and perused a copy of OERC Distribution (Conditions of Supply) Code, 2019 and understood its contents and hereby
undertake to observe and comply with the terms and conditions stipulated therein to the extent they are applicable tome/us.

23 I/We further require you to supply me/us with the necessary meter/ meters on hire in terms of section55 of the Electricity Act.2003. I/We agree to
give you such security (as per Section 47(1)(b) of the Electricity Act,2003) as may be required for the price of the meter/meters whenever called
upon to do so. (Strike out if meter to be supplied by the consumer).
24. The following are my/ our Electrical installation to be fixed in the premises.
Wattage of
Points.
Sl. No. Description of Appliances No. of Points Total Wattage.
1 Tube light
2 Incandescent lamp
3 Table fan / Fan (36")
4 Fan (48")
5 Fan (56")
6 Air Circulator
7 Music System
8 Television
9 Mixer Grinder
10 Electric Iron
11 Fridge
12 Cooler
13 Heater for cooking (according to physical availability)
14 Heater (for water heating)
15 Microwave oven
16 Washing machine
17 Kitchen Exhaust Chimney
18 Aqua guard water filter
19 Air Conditioner (1Ton)
20 Air Conditioner (1.5 Ton)
21 Geyser
22 Pump set(0.5HP)
23 Personal Computer/ Monitor & Printer
24 Industrial appliance
25 Other item (if any)
Total

The total load applied for (in KW): _____________________________

N.B. i) Addition or omissions to the connected load/contract demand to be notified to the licensee and permission obtained before effecting such
changes.
ii) The wattage against Sl. No.(24) above may be estimated as stated above (In case of non-availability of rated capacity of any item, the load
shown in Annexure-II shall be considered).
iii) The consumer shall have the option to procure meter by himself / herself from the approved vendors of the license
 25. Any electricity dues outstanding in licensee’s area of operation in consumer’s name: Yes/No

26. Any electricity dues outstanding for the premises for which connection applied for: Yes/No

27. Any electricity dues outstanding with the licensee against any firm with which the consumer is associated as an
Owner, Partner, Director or Managing Director: Yes/No

(For questions 25,26 & 27 if the answer is ‘Yes’ in any case please provide details on a separate sheet .)

28. Any application for new service connection shall be accompanied by an undertaking through affidavit that, the applicant has no outstanding dues
payable to the present distribution licensee/supplier or any other distribution licensee/supplier within the state of Odisha as per regulation 18 of
OERC Distribution (Conditions of Supply) Codde’2019.

Place:-
Date:-

Office Seal (in case of application by firms / establishments)

Signature of the applicant Name:

Acknowledgement
Received Service connection application having registration No……………. Dt………………….. from Sri/Smt. ............................................. resident of
……………………………………. For 3-ph/Single Phase/ Dom/GPS/PI/Others electricity connection in complete shape.

Signature & official Seal of

receiving officer
Name of the Section/Sub-division./Division.…………………………………
Date:-.
 Annexure-I

1. Application Form, Form – I.

2. One Passport photo.

3. Xerox copy of Money Receipt against deposit of processing fees.
4. Copy of the Treasury Challan towards deposit of inspection fees of Electrical Inspector /
Copy of Money Receipt, if deposited in TPCODL.
5. Attested copy of land document. (Patta/ Dalil/ Affidavit) where power supply is to be
effected.
6. Photo identification for urban consumers like Ration card, Voter ID card, Driving License,
Pan Card, Passport, etc.
7. Copy of the Approved Building/ Site plan from local bodies/ Development Authorities like
BDA / CDA/ PKIET, etc.
8. Indemnity Bond – If applicant is not the owner of the premises occupied by him (for
BMC/CMC/BDA/CDA area approval allotment from the concerned authority along with I-
Bond is required.
9. Xerox copy of previous month bill in case of subsequent service connections for
verification of no dues.
10. Test certificate from a licensed Electrical contractor before effecting power supply.
Test Certificate (Format)
It is hereby certified that the installation described above has been tested. The Earth reading taken
at two earth terminals is…………….Ohms. The entire installation conforms to relevant standards.

Name &Signature Seal & License No. of the Electrical Contractor.

11. Consent in the case of application by Tenant

(Format)
I…………………………………………………… being registered title holder and the absolute owner of
property located at....…………………..…...of ..................... (Local body) do hereby give my consent to
Sri/Smt. .............................................................. to avail service connection from TPCODL in his name as
consumer at the above premises. I shall inform TPCODL as end when the premises is vacated.

Name & Signature of the Owner Name & Signature of the Witness
With Con. No (if any)
12. Way-leave / permission from the adjoining consumer, if premises does not face to road.
Service connection requiring Property Crossing (Format)
I hereby give consent for drawing electric line through my/our property mentioned below
for giving electric connection to Sri/Smt.………………… ..

Name & Address of Property owner Signature of the Property Owner

With Con. No (if any)

N.B:- The Service connection application should be submitted in complete shape along with the
above documents as applicable.
 Annexure-II
Standard Rating
Sl. No. (if rating on appliance No. of Total load
Description of Appliances items (in watts)
is not available)

1 Tube light 40W

2 Incandescent lamp 60W

3 Table fan 60W

4 Ceiling Fan 70W

5 Music System 40W

6 Television 125W

7 Mixer Grinder 500W

8 Electric Iron 450W

9 Fridge 125W

10 Cooler 170W

11 Heater for cooking (according to physical 1000W

availability)

12 Heater (for water heating) 1500W

13 Microwave oven 900W

14 Washing machine 340W

15 Kitchen Exhaust Chimney 45W

16 Aqua guard water filter 30W

17 Air Conditioner (1Ton) 1500W

18 Air Conditioner (1.5 Ton) 2000W

19 Geyser 2000W

20 Pump set(0.5HP) 375W

21 Personal Computer/ Monitor & 220W

Printer

22 Other item (if any)

23 Other item (if any)

My connected load is KW Total (Watts)

 CHARGES FOR NEW SERVICE CONNECTION AS PER TARIFF ORDER 2020-21

Govt. of Orissa Service Connection Tatkal Charge

charges for Application Charge for LT (Over and above
Security Deposit Charges(in Rs.) for K.W.
Electrical Processing Fees 2 Single Phase Service Connection
connection 1 Consumers 2 Charge)
Category
Single Three
>2KW &
Single Three Single Three Up to Phase Phase
Up to 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Phase Phase Phase Phase 2KW Up to 5KW &
5KW
5KW above

Domestic Rs 34 Rs 45 Rs 50 Rs 200 Rs 1500 Rs 2500 Rs 2000 Rs 2500 240 510 880 1200 1560 1920 2360 2750 3190 3580
G.P.S Rs 75 Rs 150 Rs 50 Rs 200 Rs 1500 Rs 2500 Rs 4000 Rs 4000 1290 2740 4280 5850 7490 9070 10700 12280 13920 15490
Public
Institution Rs 75 Rs 150 Rs 50 Rs 200 Rs 1500 Rs 2500 1380 2650 4030 5300 6680 7950 9330 10600 11970 13250

1
Head of Account for Treasury Challan towards New Service Connection "0043 - Taxes & Duties (102) Fees under I.E rule 1956".
2
Additional GST @18% will be charged separately.

Type of Meter Monthly Meter Rent (Rs.) Reconnection Charges

1. Single phase electro-magnetic Kwh meter 20 Category of Consumers New Rate Applicable
2. Three phase electro-magnetic Kwh meter 40 LT Single Phase Domestic Consumer Rs.150/-

3. Three phase electro-magnetic tri-vector meter 1000 LT Single Phase other consumer Rs.400/-
4. Tri-vector meter for Railway Traction 1000 LT 3 Phase consumers Rs.600/-
5. Single phase Static Kwh meter 40 All HT & EHT consumers Rs.3000/-

6. Three Phase Static Kwh meter 150

7. Three phase Static Tri-vector meter 1000
8. Three phase Static Bi-vector meter 1000
9. LT Single phase AMR/AMI Compliant meter 50
10. LT Three phase AMR/AMI compliant meter 150

* The meter rent shall be collected for 60 months from the existing and new consumers.