Form 3

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FORM-3

(Refer to Regulation 5(7) of Tamil Nadu Electricity Regulatory Commission, TAMIL NADU
ELECTRICITY SUPPLY CODE Notification No. TNERC/SC/7/1 Dated 21.07.2004)
INDEMNITY BOND

Sub: Electricity - ………....... Distribution – Transfer of Security


Deposit and Service Connection – Premises
No,……………………………...A/c. No…………

I ………………………………… Son of/ daughter of / wife of Thiru../ Tmty ……………………………. do hereby


declare that Thiru. / Tmty……………………………………Owner of the above premises has expired on
………………and I am the legal heir to the deceased, I desire to have the security deposit and service
connections transferred in my name. I agree to indemnify the Licensee against any losses,
damages etc., arising consequent on any disputes by reason of the security deposit and service
connections being transferred to me as the legal heir to the property of late Thiru.

The Licensee shall have the right to proceed against me not only in respect of movable and
immovable properties belonging to me but also against me personally in regard to all liabilities
past, present and future claims relating to this service connection. The above facts are certified to
be correct.

SIGNATURE OF THE CONSUMER

Signed before me
Notary Public / Gazetted Officer
Station
Date

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