Proforma for Appeal | Electricity Ombudsman Delhi

Select DISCOMS *

Select DISCOMS.

Name of the Registered Consumer *

choose Name of the Registered Consumer

Name of the Complainant/Appellant *

Name of the Complainant/Appellant

Relation with the Registered Consumer *

Relation with the Registered Consumer.

Postal Address of the Appellant

Address where meter is installed

K. No. / CA No *

K. No. / CA No

Brief description of Appeal/Grievance

Ground of Appeal
Please attach separate sheet.

Relief prayed for
Please attach separate sheet.

Whether one-third amount assessed as per the CGRF’s order is paid? *

Yes

Whether one-third amount assessed as per the CGRF’s order is paid?

If Yes, Please attach separate sheet.

Whether the appeal is being filed within the stipulated period of 30 days from the date of receipt of CGRF’s order If not, specify reasons for delay

Yes

Whether the appeal is being filed within the stipulated period of 30 days from the date of receipt of CGRF’s order If not, specify reasons for delay

I/We undertake that the above matter/complaint/grievance is not pending before any other Court, Authority or Forum nor any such was earlier decided by any Court, Authority or Forum. I also state that my/our grievance(s) does not pertain to Sections 126, 127,135, 139, 143, 152 and 161 (involving theft/DAE etc.) of the Indian Electricity Act 2003

I/We solemnly declare that to the best of my/our knowledge and belief, the information given in this appeal, and in the accompanying statements/ documents are correct, complete and truly stated

List of documents enclosed.

Signature Please attach separate sheet.

Remark

ELECTRICITY OMBUDSMAN Government of nct of Delhi

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