EASTERN POWER DISTRIBUTION COMPANY OF A.P. LIMITED
Customer Service Center : SEETHAMADHARA (CSC)
OPERATION CIRCLE, VISAKHAPATNAM
TRANSFER APPLICATIONS FORM
I………………………………………………………………….…………….hereby transfer my Service Connection
No………………………………at Door No…………………………………….Street………………………….………………………..
Town ………………………………….…………….. To Sri/Smt/Kum……………………………………………………........with
Security Deposit Rs……………………………… (Rupees………………………………………………………………………………).
Pledged by me. As I have ( 1 ) left the house or ( 2 ) sold the house or ( 3 ) mortgaged and I have
nothing to do with the service from hence forth, as I have for gone all rights in the service
connections.
Signature of the Transferor
I…………………………………………………………………………………..…………..hereby agree to transfer said service
Connection of Sri/Smt./Kum………………………………………….……at door no………………………………
Street………………………………………………..town…………………………………….with the Security Deposits as I
have taken possession of the said premises forms/Smt./ Kum…………………………………………………………I
hereby agree to abid by the conditions of the agreement for requisition entered into by
Sri/Smt./Kum…………………………………………………………………With the Licensee/Discom. I agree to execute
the agreement and L.T requisition and abide by the conditions laid down by the licensee/Discom if
required.
Signature of the Transferee