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(2) NOMINATION PARTICULARS (OPTIONAL)

NAME OF NOMINEE IN FULL                    FIRST NAME            
                                       

                                                   SURNAME
                                       
Address in full
                                       
   
                                       
    
                                       

Pin Code
           

PHONE NO

             
Signature of Payer 
TAX STATUS OF PERSON MAKING THE ADVANCE (PAYER)

(Optional -unless specified,TDS shall be at highest rate)

 
RESIDENT INDIVIDUAL
 
HUF
 
DOMESTIC COMPANY
 
TRUST
 
ANY OTHER .......

(PLEASE SPECIFY)
DETAILS OF COPY OF BILL SUBMITTED (BILL MONTH NOT EARLIER THAN 2 MONTHS FROM DATE OF APPLICATION)
L.T.CONSUMER

NO. ...........................................
BILL FOR MONTH OF ............................
NET BILL

AMOUNT (Rs.) .....................................
Form 15H SUBMITTED (please tick) 
Yes       No     
FOR OFFICE USE ONLY
ADVANCE AMOUNT (Rs) 
             
RUPEES (IN WORDS)   .................................................................................... .........................................................................................................
DATE OF REALISATION
               
D D M M Y Y Y Y
CONSUMER NO
                     
CRES A/C NO.
               
FOR USE AT COLLECTING BANK
BANK & BRANCH CODE
BRANCH SCROLL NO
DATE OF RECEIPT
 Signature of Payer  
Date
Place
-----------------------------------------------

TEAR OFF SLIP----------------------------

 ------------------------------------------------
Application No C 612894  (TO BE COMPLETED BY THE APPLICANT) ACKNOWLEGEMENT SLIP TO BE RETAINED BY THE COLLECTING BANK
Date ..................................2002
Received from Mr./Mrs./Ms.  ................................................................................................................................................(Name of Payer)
Application for "CRES" duly filled in along with Rs. .......................................................................... (Rupees.................................. only ) by
Cash **/Cheque*/Demand Draft * No.  ................................ dated............................ drawn on .............................. (Banker name and
address ) for adjustment against bill for Consumer No. ......................................................................
* Subject to realisation
** For advance paid in cash,please write details of denominations

For CESC LIMITED/Collecting Bank 
-----------------------------------------------

TEAR OFF SLIP-------------------------

 ------------------------------------------------
Application No C 612894  (TO BE COMPLETED BY THE APPLICANT)

Registered Office : CESC House Chowringhee. Square,Kolkata. 700 001

(To be issued only by the Company/Collecting Bank)

 

 ACKNOWLEGEMENT SLIP FOR THE PAYER
Date ..................................2002
Received from Mr./Mrs./Ms.  ..................................................................................................................................................(Name of Payer)
Application for "CRES" duly filled in along with Rs. .......................................................................... (Rupees.................................. only ) by
Cash **/Cheque*/Demand Draft * No.  ................................ dated............................ drawn on .............................. (Banker name and
address ) for adjustment against bill for Consumer No. ......................................................................
* Subject to realisation

For CESC LIMITED/Collecting Bank