Fill in Electricity Connection Transfer Affidavit

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Electricity Connection Transfer Affidavit

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ELECTRICITY CONNECTION TRANSFER AFFIDAVIT

I, __________, __________, resident of __________, holding __________, ordinarily resident within __________ (the "Deponent" or "I"), do hereby solemnly affirm and declare as follows:

1. THE CONNECTION

2. REASON FOR TRANSFER

3. DUES

4. SAFETY UNDERTAKING

4.1 I undertake to use the connection only at the premises stated above, for the category of use stated above, and to comply with the distribution office's safety and inspection requirements. I confirm that the internal wiring, meter board and earthing at the premises have been checked and are safe.

5. DECLARATION

VERIFICATION

DEPONENT

Signature: ______________________________
__________

ATTESTATION

Notary Public / Oath Commissioner
Registration No. and seal: ____________________

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