ELECTRICITY SUPPLY For Office Use

Application No : NC-000-061-3063
APPLICATION Service Request No :
TECHNICAL DETAIL Service Notification No :

Please note that only submitted application with complete and correct information will be processed.
PART 2: APPLICATION DETAILS:
Applicant MyKad/Passport No. or Company Registration No. : 690306-05-5145
Type of Application : SUPPLY APPLICATION - NEWLY BUILT

DETAILS OF PREMISE WHICH REQUIRES THE ELECTRICITY SUPPLY:

Name : RAVI A/L SUBRAMANIAM
Address : ,6303,KG CHINCANG,SALAK,43900 SEPANG,SELANGOR

GPS Coordinate : 2.45474/101.45037 TNB Station : TNB SEPANG

TECHNICAL DETAILS:
Premise Type : DOMESTIC Premise Activity : RESIDENCE: BUNGALOW (> 1 STOREY)

Meter Location : DEPAN RUMAH Voltage Level : 400 V OPC

Supply Type : UNDERGROUND CABLE No.Of Pole : N/A

Power Consumption : OPC Meter Type : 3 PHASE

LOAD DETAILS: CONTRACTOR ACKNOWLEDGEMENT:

Total Load Connected Maximum Demand Signature, Company's name & Stamp, Address, Tel. No., Registration Copy
of JBEG/ST
New or Existing Load (kW) 15 12

Additional Load (kW) 0 0

Total Load (kW) 15 12

Welding Set Load (kVA) 0 0 I / We hereby confirm that the electrical wirings have been examined and
verified as in good condition as per Energy Commission's standards, and I
/ We acknowledge that all information given are true and TNB shall not be
liable for any action due to the information given

FOR TNB OFFICE USAGE:

Existing Existing Application No. NC-000-061-3063
Tariff
New Deposit New Service Notification No.
(RM)
Additional MWCS / PPP No.

Total

Date of Supply (Contract Date) : / /

DD MM YYYY

Reviewed By : Approved By :

Employee Name : Employee Name :

Employee No. : 100_____ Employee No. : 100_____

Sign & Stamp : Sign & Stamp :

Date : Date :

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