Price: `1
CPDCL
PDCL Name Change Application Form
Name Changes Request Details:-
Paste here your
Service Connection Number*:: ___________
_____________________________________________
recent passport
Circle Name*: Anathapur Kurnool Mahaboobnagar Medak Nalgonda size photograph
ERO Code*: ______________________________
___________________________________
Consumer Details:-
Consumer Details Actual Details Changed Details
Surname
Name
Father Name
Caste
Mobile Number
Service Type: ____________________________
___________________ Reason for Name Change: __________________________________________
Location of Premises:-
House No*: ______________Street*: _________________________
________________________________________________________________
_______________________
Circle*: Anathapur Kurnool Mahaboobnagar Medak Nalgonda
Mandal *:____________________________
______ Village*: _______________________________
_ Pin Code: _________________
___
Section Name: _________________________________ Location Type*:
Type Urban Rural
Location Name*: ___________________________________________
____________________________________ Load Connected:: _____________________
_______
Dispatch No: _________________________________
_______________
Informant Details:-
Aadhar Number: ______________________________
______________________________Informant Name*: ________________________________
_________________________________
Relation*: _________________ Door No: _________________ Locality/Land Mark: ___________________________________
_________________
District*: _________________________
_________ Mandal
Mandal*: __________________________ Village/Ward*:: _______________________
_______
Pin Code: ___________________ Mobile **: _____________________________ Phone: ________________
_______________________
Email: ____________________________________________
________________________________________________ Delivery Type*:
Type Manual
Security Deposit (Available) *:: __________
_______________________
Proof Document*: Gift Deed Sale Deed Ownership Certificate Indemnity Bond
ID Proof*: Aadhar Card Copy Driving Licen
License Copy Electoral Copy Pan Card copy Ration card copy
Document List: - (NOTE: All Upload Documents are in PPDF Format Only)
Application Form*
ID Proof*
Caste Certificate (Mandatory if SC/ST) *
Owner Ship Certificate/Sale Deed/Gift Deed (Selected Proof Document) *
Municipality/Gram panchayat Permission Letter
Letter*
Indemnity Bond*
Transfer Transferee Document
Document*
Latest Bill and Receipt*
Applicant’s Signature