Applicant Type *:
Application Type *:
Tatkal Connection is applicable to only domestic(A.E.H) and commercial lighting
Maximum load should be 5kW/6.7HP & Line Extension is not needed. Not applicable to MSB/Layouts/Complexes/
A surcharge of Rs.1000/ for each installation shall be paid in addition to the regular connection charges
First name *
Last Name
Father's Name/Husband's Name *
Name of the Nominee (Optional)
Email ID*
Mobile Number *
ID Number*
Company Name *
Authorized Signatory and Designation
Phone Number
Address Line1 *
Address Line2
Address Line3
City
Division *
Pincode*
Sub Division Office * :
Section Office * :
Connection Type *:
Power Supply required for *:
Requested Load(kW)*:
Required Voltage * :
Phase Requirement * :
LEC Name :
Contractor Class :
License No :
Supervisor Permit No :
Address of the LEC
Installation #1
Please Enter Account ID/RR Number :
Installation #2
Installation #3
Nearest Pole ID if any :
Site Type *:
Ownership Type :
Built up Area(Square Meters):
Copyright 2018, Zygox
