Spdcl Name Change Application Form

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Price: `1
SPDCL
PDCL Name Change Application Form
Paste here your
recent passport
Name Changes Request
Details:-
size photograph
Service Number*: __________________________________________
_________________________________
Consumer
Details:-
S.No
Consumer Details
Actual Details
Changed
Changed Details
Surname
1
Name
2
3
Father Name
Caste
4
Mobile Number
5
Service Type: ____________________________
___________________ Reason for Name Change: __________________________________________
__________________________________________
Location of Premises:-
House No*: ______________Street*: _________________________
________________________________________________________________
_______________________
Circle*:
GUNTUR
KADAPA
NELLORE
NELLORE
ONGOLE
TIRUPATHI
VIJAYAWADA
Division *:___________________________
___ Sub Division*: ______________________________ Pin Code: ___
_ Pin Code: _________________
Sub Category: ________________________________
: ____________________________________________________
Location Type
Location Type*:
Urban
Rural
Location Name*: ___________________________________________
____________________________________ Load Connected: _______
: _____________________
Dispatch No: _________________________________
_______________
Informant Details:-
Aadhar Number: ______________________________
Aadhar Number: ______________________________Informant Name*: ________________________________
_________________________________
Relation*: _________________ Door No: ______
_________________ Locality/Land Mark:____________________________
____________________________
State*:_____________________District*: ______
: _________________________ Mandal*: ____________________
______
Village/Ward*: ____________________Pin Code: _________________Mobile Number
__Pin Code: _________________Mobile Number*: ___________________
___________
Email ID: ___________________________________
__________________
Delivery Type*:
Manual
Security Deposit (Available) *: __________
: _______________________
Proof Document*:
Gift Deed
Sale Deed
Sale Deed
Ownership Certificate
Indemnity Bond
ID
Proof*:
Aadhar Card Copy
Driving Licen
Driving License Copy
Electoral Copy
Pan Card copy
Ration card copy
Ration card copy
Document List: -
(NOTE: All Upload Documents are in P
(NOTE: All Upload Documents are in PDF Format Only)
Application
Form*
ID
Proof*
Caste Certificate (Mandatory if SC/ST)
Caste Certificate (Mandatory if SC/ST)
*
Owner Ship Certificate/Sale Deed/Gift
Owner Ship Certificate/Sale Deed/Gift Deed (Selected Proof Document)
*
Municipality/Gram panchayat Permission Letter
Municipality/Gram panchayat Permission
Letter*
Indemnity
Bond*
Transfer Transferee Document
Transfer Transferee
Document*
Latest Bill and
Receipt*
Applicant’s Signature
Applicant’s Signature

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