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Application Form G (Vide Rule-7)
Distributor or Producer or Generating Company Details
Name of the distributor/franchise/producer or generating company
*
Corporative office Address
*
Installation address
*
Style of business(Purpose of use of Electricity)
*
Return for month and year (MM/YYYY)
*
Name of sign authority (On behalf of Distributor/Franchise/Produce/Generating Company)
*
Designation of authorized person
*
Signed Date (DD/MM/YYYY)
*
Distributer/Producer Name
*
For the Month (Consumption Month)
*
Email id:
*
Mobile Number:
*
Electrical energy sold or supplied for consumption for light, fans or any other appliances normally connected to a lighting circuit in premises used for business, trade, commerce or for professional pursuits, including temporary connections at such premises covered by form ‘AA’ .
KVA
*
---Select---
0- 500 (L.T)
Above 500 to 5000 (H.T)
Above 5000 (E.H.T)
Supplier :
Select
Open Access (For Consumption of electricity obtained through open access from outside the state. )
Generating Company (Electricity sold or supplied by generating company, producer and captive generating plant to any consumer in the state)
Captive Generating plant (Producer) (For the electricity consumed by captive generating plants, producers generating companies for their auxiliary consumption and for their own consumption.)
In respect of station :-
S NO.
Consumer Category
Details of Genrator/Station
Details of Current Transformer
Details of Potential Transformer
Details of energy Meter
Multiplying Factor
Unit
Tariff
ED %
Electricity Duty Total= (Unit*Tariff*ED %)
KVA
Make/ Module
Serial number
Make/ Module
Serial number
Ratio
Make/ Module
Serial number
Ratio
Make/ Module
Serial number
IR
FR
Diffrenece (IR-FR)
1.
Select
1.Generating Company
2.Captive Generating plant (Producer)
3.Open Access
For any other class not included Sr no A to E
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Part B: If customer has taken Electricity through Open Access
S NO.
Name of Open Access Supplier
Unit Supplied to the consumer
Tariff (Rs/Unit)
ED %
Electricity Duty
1.
*
*
*
*
*
S NO.
Consumer Category
Details of Genrator/Station
Details of Current Transformer
Details of energy Meter
Multiplying Factor
Unit
Tariff
ED %
Electricity Duty Total= (Unit*Tariff*ED %)
KVA
Make/ Module
Serial number
Make/ Module
Serial number
Ratio
Make/ Module
Serial number
IR
FR
Diffrenece (IR-FR)
1.
Select
1.Generating Company
2.Captive Generating plant (Producer)
3.Open Access
For any other class not included Sr no A to E
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Note: Provided that if Electricity sold or supplied for consumption for any one purpose, is used either wholly or partially, without the consent of distribution licensee or Franchisee, as the case may be, for consumption or any other purpose for which a higher rate of duty is chargeable the entire sold or supplied shall be charges at the highest rate applicable.
Note: Provided that if Electricity sold or supplied for consumption for any one purpose, is used either wholly or partially, without the consent of distribution licensee or Franchisee, as the case may be, for consumption or any other purpose for which a higher rate of duty is chargeable the entire sold or supplied shall be charges at the highest rate applicable.
Total units Dutiable
*
NO
Yes
Total units Dutiable Form Selection :-
Form AA
Form B
Form C
Form D
Form E
Form F
FORM AA
Name of consumer
Address of consumer or Account No.
Existing service connection No. if any
Purpose of temproray connection or Extenstion
period of temproray connection
connection load in K.W
Units Consumed
Tariff(Rs/Unit)
ED %
Amout of duty
From(DD/MM/YYYY)
To(DD/MM/YYYY)
No. of days
From Temproray connection(DD/MM/YYYY)
From extention of existing connection(DD/MM/YYYY)
Total
*
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM B
[ vide Rule 7 ]
Electrical Energy sold or supplied for consumption for light , fans or any other appliances normally connected to a lighting circuit in premises used for business , trade , commerce or for professional pursuits , including temporary connections at such premises covered by form “AA”
Name of consumer
Address of consumer or Account No.
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
Metered
Computed
Total
Units
Class of exemption (vide Sec.4)
Units
Tariff (Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM C
[ vide Rule 7 ]
Electrical energy sold or supplied with the premises of a factory :-
(a) for lighting in all departments of the factory including canteen
(b) for fans used for humidification therein
but excluding electrical energy consumed for domestic purposes in a factory .
Name of consumer
Address of consumer or Account No.
Factory Licence
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
No
Date of expiry(DD/MM/YYYY)
Metered
Computed
Total
Units
Class of exemption (Vide Sec. 4)
Units
Tariff(Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM D
[ vide Rule 7 ]
Electrical energy sold or supplied for light, fans or any other appliances normally connected to a lighting circuit others than that covered by forms ‘AA’ to ‘C’
Name of consumer
Address of consumer or Account No.
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
Metered
Computed
Total
Units
Under Class of exemption (vide Sec. 4)
Units
Tariff(Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM E
[ vide Rule 7 ]
Electrical energy sold or supplied for purposes other than those covered by forms ‘AA’ to ‘D’ in premises used for residential business, trade or commercial purposes or for purposes of professional pursuits.
Name of consumer
Address of consumer or Account No.
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
Metered
Computed
Total
Units
Under Class of exemption (vide Sec. 4)
Units
Tariff(Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM F
[ vide Rule 7 ]
Electrical energy sold or supplied other than that covered by forms ‘AA’ to ‘E’.
Name of consumer
Address of consumer or Account No.
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
Metered
Computed
Total
Units
Under Class of exemption (vide Sec. 4)
Units
Tariff(Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
Energy covered by form No
Particulars in Brief
Total No. of Consumer
Dutiable Units
Amount of Electricity Duty
Category
Metered
Computed
Total
Tariff(Rs/Unit)
ED
1. Form AA
Temporary supply marriage and social functions.
*
*
*
*
*
*
*
2. Form B
Lights-commercial etc.
*
*
*
*
*
*
*
3. Form C
Lights-Factory
*
*
*
*
*
*
*
4. Form D
Other Lights
*
*
*
*
*
*
*
5. Form E
Power—residential, commercial etc.
*
*
*
*
*
*
*
6. Form F
Power---Other purposes
*
*
*
*
*
*
*
Total Units Non Dutiable
*
NO
Yes
Total units Non Dutiable Form Selection :-
Form B
Form C
Form D
Form E
Form F
FORM B
[ vide Rule 7 ]
Electrical Energy sold or supplied for consumption for light , fans or any other appliances normally connected to a lighting circuit in premises used for business , trade , commerce or for professional pursuits , including temporary connections at such premises covered by form “AA”
Name of consumer
Address of consumer or Account No.
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
Metered
Computed
Total
Units
Under Class of exemption (vide Sec. 4)
Units
Tariff(Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM C
[ vide Rule 7 ]
Electrical energy sold or supplied with the premises of a factory :-
(a) for lighting in all departments of the factory including canteen
(b) for fans used for humidification therein
but excluding electrical energy consumed for domestic purposes in a factory .
Name of consumer
Address of consumer or Account No.
Factory Licence
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
No
Date of expiry(DD/MM/YYYY)
Metered
Computed
Total
Units
Class of exemption (Vide Sec. 4)
Units
Tariff(Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM D
[ vide Rule 7 ]
Electrical energy sold or supplied for light, fans or any other appliances normally connected to a lighting circuit others than that covered by forms ‘AA’ to ‘C’
Name of consumer
Address of consumer or Account No.
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
Metered
Computed
Total
Units
Class of exemption (vide Sec.4)
Units
Tariff(Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM E
[ vide Rule 7 ]
Electrical energy sold or supplied for purposes other than those covered by forms ‘AA’ to ‘D’ in premises used for residential business, trade or commercial purposes or for purposes of professional pursuits.
Name of consumer
Address of consumer or Account No.
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
Metered
Computed
Total
Units
Class of exemption (vide Sec.4)
Units
Tariff(Rs/Unit)
ED %
*
*
*
*
*
*
*
*
*
*
*
*
*
FORM F
[ vide Rule 7 ]
Electrical energy sold or supplied other than that covered by forms ‘AA’ to ‘E’.
Name of consumer
Address of consumer or Account No.
Meter reading of previous month
Meter reading of present month
Units supplied during the month
Exempted units
Dutiable Units
Amount of duty
*
*
*
*
*
*
*
*
*
*
*
*
*
Energy covered by form No
Particulars in Brief
Number of consumers and units exempted under sections
No. of consumer / units
(Central Govt)
(Railways)
(State Govt)
(Street Lts)
(Irrigation)
(P.H- Aux.)
(Under State Govt. Order)
Total Units
1.Form ‘B’
Lights Commercial etc
*
*
*
*
*
*
*
*
*
2.Form ‘C’
Lights Factory
*
*
*
*
*
*
*
*
*
3.Form “D’
Other Lights
*
*
*
*
*
*
*
*
*
4.Form ‘E’
Power residential
*
*
*
*
*
*
*
*
*
5.Form ‘F’
Power Other purposes
*
*
*
*
*
*
*
*
*
CERTIFICATE
IT IS CERTIFIED that (a) the above figures are correct to the best of my/our knowledge and belief, (b) no supply which is dutiable under the M.P. Electricity Duty Act 2012 had been exempted, and (c) the rates of Electricity Duty charged are as per the Act .
Total units accounted for Dutiable
*
Total units accounted for Non Dutiable
*
