Gas Connection Transfer Application Affidavit

G-A

APPLICATION FOR TRANSFER OF GAS CONNECTION AFTER DEATH OF CONSUMER

To,

M/s ..........................................................

.................................................................

District ...................................................

Subject: Application for Transfer of Gas Connection after Death of Consumer

Dear Sir/Madam,

I, ................................................, aged ........ years, S/O / W/O / D/O ........................................, resident of .........................................................................................., District ........................................, respectfully submit that:

1-That my………………........................................................... (relation), namely Shri/Smt. .........................................................., was the holder/consumer of a Domestic LPG / Commercial LPG / PNG (Piped Natural Gas) / any other gas connection with your agency, bearing SV No./Connection No./Consumer No./BP No./CA No. ........................................, dated .......................................

2-That Shri/Smt........................................................... expired on...................................... An attested copy of the death certificate is enclosed herewith.

3-That I, being the.................................................. (relation) of the deceased consumer, request you to kindly transfer the said gas connection in my name.

4-I am ready to submit all the required documents and to pay the applicable security deposit / transfer charges / equipment charges as per your rules.

5-I undertake to indemnify your agency/company against any claim that may arise in future regarding the transfer of the said gas connection in my name.

6-I declare that the above statements are true and correct to the best of my knowledge and belief.

7-Kindly process my application at the earliest.

Therefore, I humbly request you to kindly transfer the aforementioned gas connection of the deceased into my name, following his/her demise.

Thanking you,

Yours faithfully,

Date:
Place:

Signature: .............................................
Name: ...................................................