ANNEXURE - A

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APPLICATION FORM FOR EXEMTION FROM PAYMENT OF ELECTRICITY DUTY ON GRIDCO POWER.

1.  Name and address of the unit                           :

2.  District and zone where located                        :

3.  Status of the Industrial unit                                 :

  (Small/Medium/Large/Heavy and poor intensive).

4.  Name and address of the proprietor/Executive :

5.  Registration No. and authority License No.      :

6.  Main item of manufacture                                 :

7.  Initial capital outlay showing the capital

    outlay on land and building, plant and

    machinery separately.

8.  Consumer No. of the Industry                         :

9.  Connected load/Contract demand                   :

     allowed to the industry by OSEB

     (A Photostat copy of the agreement with

     OSEB should be enclosed).

10.  Date of first investment in land/building/Plant

       & M/C                                                          :

11.   Date of starting production                             :

12.   Date of supply of power by OSEB                :

13.  Whether IPR-1980, 1986, 1989, 1992

       & 1996 is applicable to the industry and

       reason thereof.                                               :

14.  Extent of exemption of electricity duty and

       the period for which exemption applied

              

 

                I hereby declare that the facts stated above are true to the best of my knowledge.

Date                                                                                                                         Signature of the Proprietor.

OFFICE OF THE GENERAL MANAGER : D.I.C., KEONJHAR.

                  Certified that the information furnished as above has been verified and found correct. The industrial unit is eligible for exemption under IPR …………… for which application is filled.

DOCUMENT REQUIRED FOR ED EXEMPTION (IN DUPLICATE)

1.                     application form duly filled in.

2.                     Copy of PMT/IL/LNEN

3.                     Contracted load/contract demand allowed to the industry by GRIDCO should be enclosed).

4.                     Consumer No. of Industry.

5.                     Copy supporting documents regarding

6.                    Certificate containing the date of supply of power by GRIDCO.

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