FORM-1 (Free of Cost.

)
Registration No.& Date
Office Use

Con No Connected Load

(in kW) Space for Photograph
Date of Connection--
Tariff
Purpose
CENTRAL
CENTRAL ELECTRICITY SUPPLY UTILITY OF ORISSA
ELECTRI
Head Office: IDCO Towers, 9th Floor, Jan path, Bhubaneswar – 751 022
Phone no: 0674-2541727,
CITYFax No: 0674-2543125
Website: www.cescoorissa.com
SUPPLY
Application for Service Connection
(For Non-Industrial LT Consumers)
Re-effecting Service
New Service Connection Temporary Service
1 Please Tick ( √ )
Others (Specify)
Revising Connected Load Ownership Change
2
Name of Ele. Section.
Name of the Sub-Divn.
Name of the applicant/ Consumer Con. No.(If existing consumer)
4
3
5 e-mail
6 Location Details
Address of Premises (where supply is required) 7
Plot No.-
Street-
Area/ Sahi/
Sector
Village/ Town/
City
P.S.
Mobile No:-
8
Permanet Address(with Land phone no, if any) Address for communication
9
(If different , where supply is required). (with Land phone no, if any)

Pin: Mob:- Pin: Mob.:

10 Nearest Electric Pole No. 11 Nearest Con.No
12 Purpose of availing Service Connection Dom GPS PI Others
13 Single Phase/3Phase 14 Total connected Load ……………………….KW
Yes / No Distance (in metre) from nearest Pole to Meter Box
Whether Phase Addition / OH line / Pole is required
15 16
for effecting Service Connection
Not Known
Status of applicant If tenant, whether
Owner /
17 18 consent of owner is Yes / No
Tenant
(Strike out whichever is not applicable obtained?

CENTRAL ELECTRICITY SUPPLY UTILITY OF ORISSA

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-divn./Divn.…………………………………
Date:-.
 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 payble and shall also
pay the charges, surcharges, electricity duty in accordance with the OERC Distribution (Conditions of Supply) code-
2004 provided that annual sum payble 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, payble under Regulations 84 and 85 of
the OERC Distribution(Condition of supply) code,2004.
22 I / We have obtained and perused a copy of OERC Distribution (Condition of supply) code,2004 and understood its
contents and hereby undertake to observe and comply with the terms and conditions stipulated therein to the extent
they are applicable to me/ 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.
No. of Wattage of
Sl. No. Description of Appliances Total Wattage.
Points Points.
1 Tube light
2 Incandescent lamp
3 Table fan / Fan (36")
4 Fan (48")
5 Fan (56")
6 Air Circulator
7 Music System
8 Telivision
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 Exhust Chimney
18 Aqua guard water filter
19 Air Conditioner (1Ton)
20 Air Conditioner (1.5 Ton)
21 Geyser
22 Pumpset(0.5HP)
23 Personal Computer/ Monitor & Printer
24 Industrial appliance
25 Other item (if any)
My Connected demane is ………………………………… KW/KVA

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 asstated above(In case of non-availability of rated
capacity of any item, the load shown in Annexure-II shall be considered).

Place:-
Date:-

Office Seal (incase of application by firms/establishments) Signature of the applicant

Name-
 Annexure- I

CENTRAL ELECTRICITY SUPPLY UTILITY OF ORISSA

CHECK-LIST-FOR CONSUMER

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 CESU.
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, Pass Port 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 CESU in his name as consumer at the above premises. I
shall inform CESU 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 (if Total

No. of
Sl. No. Description of Appliances rating on appliance is not load (in
items
available) watts)

1 Tube light 40W

2 Incandescent lamp 60W
3 Table fan 60W
4 Ceiling Fan 70W
5 Music System 40W
6 Telivision 125W
7 Mixer Grinder 500W
8 Electric Iron 450W
9 Fridge 125W
10 Cooler 170W
Heater for cooking (according to
11 physical availability) 1000W
12 Heater (for water heating) 1500W
13 Microwave oven 900W
14 Washing machine 340W
15 Kitchen Exhust Chimney 45W
16 Aqua guard water filter 30W
17 Air Conditioner (1Ton) 1500W
18 Air Conditioner (1.5 Ton) 2000W
19 Geyser 2000W
20 Pumpset(0.5HP) 375W
Personal Computer/ Monitor &
21 Printer 220W
22 Other item (if any)
23 Other item (if any)
My connected load is KW Total (Watts)

Public Institution
CHARGES FOR NEW SERVICE CONNECTION
Govt. of orissa
Service
charges for Application
Category connection Security Deposit Charges(in Rs.) for K.W.(Applicable for the Fy-2010-11)
Electrical Processing Fees
charges
connection
Single Three Single Three
0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Phase Phase Phase Phase
Rs 1000/-
Domestic Rs 34 Rs 45 Rs 25 Rs 100 (Materials to be 141 242 400 623 876 1131 1456 1752 2077 2372
supplied by CESU,)
Rs200/-(Materials
G.P.S Rs 75 Rs 150 Rs 25 Rs 100 985 2130 3353 4628 5952 7226 8551 9828 11150 12424
to be supplied by
the consumer)
Public
Rs 75 Rs 150 Rs 25 Rs 100 1007 1914 2922 2328 4836 5743 6750 7658 8665 9572
Institution

* Head of Account for Treasury Challan towards New Service Connection

"0043 - Taxes & Duties (102) Fees under I.E rule 1956"