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ANNEXURE - I LOAD DECLARATION FORM Date Consumer Name Address Consumer No. Old New Contract Demand in KW/KVA Tariff Division/Sub-Division/Section Meter Status OK / Defective / Burnt Power Supply Status Connected / Disconnected Sl. No. Description of Appliances Tube light Incandescent lamp CFL Table Fan Ceiling Fan 48 56 Music System Television Mixer Grinder Electric Iron Fridge Cooler Heater for cooking according to physical availability Heater for water heating Microwave oven Washing machine Kitchen Exhaust Chimney Aqua guard water filter Air Conditioner 1Ton 1. 5 Ton etc* Geyser Pumpset 0. 5HP 1. 0 HP etc* Personal Computer/ Monitor Printer Industrial appliance Other item if any TOTAL No* of Points Wattage of Points Total Wattage My Declared Load is. KW/KVA In case my declared load is more than contract demand I agree to deposit the additional security amount. Place Signature of Consumer NOTE The wattage against Sl* No* 22 above may be estimated as stated above In case of non-availability of rated capacity of any item the load shown in Annexure-II shall be considered LOAD DETAIL OF ELECTRICAL APPLIANCES Standard Rating if rating on appliance is not available 40 W 60 W 70 W 1000 W availability 45 W 30 W 1500 W 2000 W. 5 Ton etc* Geyser Pumpset 0. 5HP 1. 0 HP etc* Personal Computer/ Monitor Printer Industrial appliance Other item if any TOTAL No* of Points Wattage of Points Total Wattage My Declared Load is. KW/KVA In case my declared load is more than contract demand I agree to deposit the additional security amount. KW/KVA In case my declared load is more than contract demand I agree to deposit the additional security amount. Place Signature of Consumer NOTE The wattage against Sl* No* 22 above may be estimated as stated above In case of non-availability of rated capacity of any item the load shown in Annexure-II shall be considered LOAD DETAIL OF ELECTRICAL APPLIANCES Standard Rating if rating on appliance is not available 40 W 60 W 70 W 1000 W availability 45 W 30 W 1500 W 2000 W. 5 Ton etc* Geyser Pumpset 0. 5HP 1. 0 HP etc* Personal Computer/ Monitor Printer Industrial appliance Other item if any TOTAL No* of Points Wattage of Points Total Wattage My Declared Load is. KW/KVA In case my declared load is more than contract demand I agree to deposit the additional security amount. Place Signature of Consumer NOTE The wattage against Sl* No* 22 above may be estimated as stated above In case of non-availability of rated capacity of any item the load shown in Annexure-II shall be considered LOAD DETAIL OF ELECTRICAL APPLIANCES Standard Rating if rating on appliance is not available 40 W 60 W 70 W 1000 W availability 45 W 30 W 1500 W 2000 W. .

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