WELCOME TO NDMC WATER SERVICES

()

Application for sanction of water connection

(Fields marked * are mandatory)
Applicant Details

   Application Number*
Application Date*


Connection Category*
Choose Category*

Note:- The Application shall refer the applicable tariff schedule available on NDMC/DERC website for correctt tariff category. In case of any doubt, the application shall seek help of NDMC/DERC.

* based on funding pattern as per tariff sehedule.

Applicant Full Name*
(Max length 50 chars)
Name of Father/Husband/Director/Pratner/Trustee*
(Max length 50 chars)

Address at which supplay is required

House No*
(Max length 50 chars)
Street*
(Max length 100 chars)

Colony/Area*
(Max length 50 chars)
Pincode*
(Max length 6 chars)

Telephone Number
(Max length 8-12 chars)
Mobile Number*
(Max length 10 chars)
Email Address*
(Max length 50 chars)

Adress For Communication/Billing

House No*
(Max length 50 chars)
Street*
(Max length 100 chars)

Colony/Area*
(Max length 50 chars)
Pincode*
(Max length 6 chars)

Telephone Number
(Max length 8-12 chars)
Email*
(Max length 50 chars)

Install your own Bureau of Indian Standards approved meter: YES/No.

Nearest Landmark Pole No./Feeder pillar No./Nearest H.No. and New KS No.(if any):

Particulars of the premises to be connected:-
Size of Conncetion applied for (In Kilo Liter)

Purpose of Supply


List of Document Attached

* Documents with maximum size of 2 MB can be uploaded. The supported formats are JPEG and PDF.

Please upload any one

*

Upload Applicant Photo (Passport size)*

Upload Signature (Signature of applicant)*

Upload Scaned copy of AFFIDAVIT Form (must be attested by Notary Public with Rs 10 Stamp)*

Upload Scaned copy of DECLARATION/UNDERTAKING (Enclosure to ANNEXE-I) Form*

*** Submit 'AFFIDAVIT' and 'DECLARATION/UNDERTAKING' form after application approval at the counter.

Declaration by the Applicant

I ----------- Son/Daughter of ---------------------- resident of (here in after referred tp as "Applicant". which term shall mean and include executors administrators, heirs,successors and assign), do hereby swear and declare as under:.
  That the applicant has requested the licensee to provide a service conncetion at the above mentioned premises in the Applicant's name for the purpose mentioned in the application form.
  The grace period would be two months i.e. April and May. Thereafter the penalty @ 5% of the license fee would be charged for each subsequent month from the pet owners.