Price: ` 1
CPDCL Load Change Application Form
Service Change Type: - Load Change Paste here your
Service Connection Number*:: ___________
_______________________________________________ recent passport
size photograph
Circle Name*: Anathapur Kurnool Mahaboobnagar Medak Nalgonda
ERO Code*: ______________________________
________________
Consumer Details:-
AADHAR Card No: _____________________________
________________Consumer name *: ______________________________________
_____________________
Consumer Surname*: ____________________
_________________ Consumer Father Name*: _____________________
____________________
Social Group *: Others S.C S.T If Others: __________________________________________
_____________________
Category Type*: Domestic Commercial Commercial – Hoardings 6A – Street Lights
6B – Public Water Works General Issues
Religious Places (Temples, Church, Mosque, Govt.Schools etc) Agriculture Services
Location Type*: Urban Rural Location Name*: __________________________________________
___________________
Location of Premises:-
House No*: ____________________Locality
Locality*:_________________________________________________________
____________________________
Circle*: _________________________ Mandal
Mandal*: _________________________ Village*: __________________
______________
Pin Code: _________________ Section Name: ______________________________
Estimation Type: Turnkey Department With Estimate Without Estimate
Load Details:-
S.No Category Sub Category No of Items
Changed Load: ______________________ Reason for Change: _______________________________________________
Address for Communication:-
Door No: __________________
______ Locality/Land Mark: _______
____________________________________________________________
___________________________
District*: ________________________________________
______________________________ Mandal*: ____________________________
________________________________
Village/Ward*: ______________________________
_____________ Pin Code: _____________ Mobile Number*: ______
_____________________
Email ID: _________________________________________
_____________________ Ration Card No: _________________
______________________
Informant Details:-
Informant Name*: ___________________________
_______________________________________ Informant Relation*:: ____________________
_________
Delivery Type*: At Kiosk Security Deposit (Available) *: ______________________________________
ID Proof*: Aadhar Card Copy Driving Licence Copy Ration Card Copy Pan Card Copy Electoral Card Copy
Document List: - (NOTE: All Upload Documents are in PDF Format Only)
Application Form* Latest Power Bill with Receipt* Category and Load Change Undertaking Form*
Form
Note: Please upload Application Form and Above Documents as a single file
ID Proof *
Price: ` 1
Applicant’s Signature
