Maharashtra State Electricity Distribution Co. Ltd.

FORM "U" CHANGE OF NAME

(Address of the premises shall remain same and only the Name of the
OCCUPIER will be changed)
To, Date of Application:____________
The Billing Authority
O&M Circle/ O&M Sub-Division
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1) Name and address
 New Consumer / Transfere.:
1) Applicants Name First name Name of Father/Husband Surname
(IN BLOCK LETTERS)

2) Correction in address within same premises if any.

House No./ Survey No./Plot No.: Society Name:

Lane / Street/ Landmark : Gala/Village :

Taluka/City & District : Pin Code :

3) Email Id: (Phone No) (Mobile No)

4) Consumer No.: Category: Load (kw):

 Old Consumer / Transferor.:

1) Applicants Name First name Name of Father/Husband Surname
(IN BLOCK LETTERS)

2) Reason for Chang of Name:_______________________________________________________

3) Document enclosed (Please specify)__________________________________ (Please see Annexure “A”)
4) Arrears (if any): _____________________________________(Arrears should be Nil at the time of application)
5) Declaration.:
I hereby declare that

I will abide by the provisions of Electricity Act 2003 and Maharashtra Electricity Regulatory Commission
(Electricity Supply Code and other conditions of Supply) Regulation 2005. I will pay the electricity bill as per my
consumption and prevailing MSEDCL Tariff. I will pay arrears (if any) and security deposit as an when due as per rules.
I understand that non payment of electricity bill will attract provision of Section 56 of EA 2003. I undertake to transfer
my SD to new incoming consumer.
The above information is true and if any false information in observed, I / we will be fully responsible for the
same.
[

Signature of Old Consumer Signature of New Consumer

(Note: If old consumer wants refund of Security Deposit than fillup forms X)
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RECEIPT
This is to acknowledge the receipt of the change of name application from Shri __________________
_________________________ Consumer No. ____________________ on date ______________________

The Billing Authority

O&M Circle /O&M Sub-Division
 Annexure “A”

Document required (please tick):

Any one of the relevant document

 Certified Copy of Registered Agreement to sale and allotment letter/ possession receipt.
 Society's share certificate.
 Certified copy of Corresponding Legal Document
 Document confirming that the meter is located in his share of property
 Certificate of Incorporation issued by the Registrar or copy of High Court order
 Affidavit / Gazette Notification for himself
 Copy of the new Deed and NOC of Transferor
 Sale Deed/Gift Deed
Authority to sign the Change of Name
 This will be required only in case of Companiesl Artificial luridical Persons/ Association of
Persons/Societies etc where the ownership lies with the organization and not with the Indlvldual

FORM “X”

Refund of Security Deposit

I Shri / Smt. / M/s. ________________________________________________________, hereby give

consent to transfer the connection in the name of transferee Shri / Smt. /M/s.___________________________
________________________ . Also, the deposit held against my consumer no.________________________
may be refunded to me.

- Name of Account Holder:

- Name of Bank & Branch:
- Bank A/c no.:
- IFSC no.:
- Original Receipt no..:

Signature of New Consumer Signature of Old Consumer