HINDUSTAN PETROLEUM CORPORATION LIMITED UNIQUE CONSUMER ID: 1161383100006272

(A GOVERNMENT OF INDIA ENTERPRISE) ID CODE DOCUMENT TYPE

REGISTERED OFFICE: 17 ,JAMSHEDJI TATA ROAD 2 Termination Voucher

Open Case
MUMBAI- 400 020

DOC NO DATE FILLING PLANT NAME PLANT CODE

2001119 03/12/2024 JATNI LPG PLANT 2623
1241383100000045
CONUSMER NO. DEALER CODE DEALER’S NAME AND ADDRESS
611949 41038398 SWASTIDEEP HP GAS AGENCY
AT - MAHAKALPARA PO - MAHAKALPARA PO - MAHAKALPARA..KENDRAPARA.MAHAKALPARA
MAHAKALPADA,ODISHA 754224
CONNECTION REGISTRATION EQUIPMENT CODE NOS AMOUNT
TYPE | NATURE NO 12695 CYLINDER 036 1 1450.00
1 | 1 DATE 11/09/2016 REGULATOR 047 1 150.00
AMOUNT IN WORDS Rupees one thousand six hundred only TOTAL 1600.00
CONSUMER NAME Mr. BINATA DAS
CONSUMER ADDRESS W/O-ABHIRAM DAS AT/PO-JAMBOO
MAHAKALPARA
MAHAKALPADA,ODISHA 754224
OLD PARTICULARS DOCUMENT NO. DATE
DEALER CODE 41038398 ORIGINAL SV 1012053 29/11/2016
FILLING PLANT CODE 2623 CURRENT SV 1012053 29/11/2016
CONSUMER NO. 611949 ADDL. SV
OIL COMPANY TV/CTA/SVCD 2001119
1. Hindustan Petroleum Corporation Limited (hereinafter called “the corporation) loans to the consumer and the consumer takes on loan from the corporation, cylinders and pressure
regulators (hereinafter collectively called “the equipment”) required for the supply of the corporation’s product viz. “HP gas” (hereinafter called the “gas”).
2. The consumer shall deposit with the corporation an amount in accordance with the corporation’s tariff in force from time to time as security for the due fulfilment by the consumer of his
obligations hereunder. The corporation shall be under no obligation with regard to the manner of use or disposal of the funds received as deposit from the consumer nor shall it pay to the
consumer any interest thereon.
3. The consumer shall remain responsible to the corporation for the safe custody of the equipment and shall not sell, mortgage or otherwise dispose of the equipment or create any interest
therein or charge thereon in favour of any party.
4. The consumer shall not remove the equipment to any address other than that shown on the obverse thereof without obtaining the prior written permission of the corporation’s dealer
concerned (hereinafter called “the dealer”). Further, in the event of the consumer’s departure from the area serviced by the dealer, he shall return the equipment to the dealer.
5. The consumer shall not attempt to repair the equipment or cause or permit anyone other than the corporation to do the same and shall permit the dealer to remove the equipment for
repairs from the consumer’s premises. The consumer shall not exchange the equipment with or have the cylinder refilled by anyone other than the corporation or the dealer, not shall use the
cylinder for any purpose other than as a container for the gas supplied by the corporation.
6. The consumer shall be liable for any loss of or damage to the equipment or any part thereof and shall reimburse to the corporation the value of the missing or damaged equipment or part
thereof in accordance with the corporation’s tariff in force on the date of reimbursement.
7. The corporation and/or the dealer shall not be responsible for any failure and/or delay in supplying the gas to the consumer if such supply has been delayed/hindered or prevented by any
circumstances whatsoever be the control of the corporation and/or the dealer.
8. Any sale by the dealer to the consumer of the gas appliances and their parts and accessories including rubber tubing/ suraksha hose used for connecting the appliances to the equipment
shall be effected by the dealer on his own account and in his own right.
9. The consumer shall use only appliances of a type approved by the ISI or the corporation.
10. All necessary installation work including the connection/disconnection of cylinder to/from the appliances and/or pressure regulator and the work of repairs to appliances and the
replacement of rubber tubing will be carried out at the consumer’s expense and on his own responsibility by the dealer and not on behalf of corporation. The fact that the consumer is
supplied “HP gas” shall not be deemed to impose any liability on the corporation with regard to the fitness or otherwise of the installation and/or repair work. The corporation and/or the
dealer and/ or the person authorised by either or them shall, however, have the right to inspect the installation at any time and, if considered necessary, for reasons of safety, to refuse to
supply the gas to the consumer.
11. The corporation shall not be liable for any loss or damage caused to any person or property as a result of the installation and/or the use of the gas by the consumer. In the event of any
accident involving the consumer’s installation, he shall forthwith inform the dealer.
12. The corporation as well as the consumer shall be at liberty to terminate the contract at any time by giving 15 days’, notice in writing. On termination of this contract the consumer shall
forthwith return the equipment to the corporation and/or the dealer, thereafter refund the balance of the deposit made by the consumer with the corporation after deducting therefore such
amounts, if any, as may be due to the corporation.
13. As per the gazette of India notification dated 10th September, 2009 on LPG control order, 2000 a “household” means a family consisting of husband, wife, unmarried children and
dependent parents living together in a dwelling unit having common kitchen can have one LPG connection in their “household” and in case if such family is having or avails a piped natural gas
connection of any company then the LPG connection will be surrendered within 60 days failing which HPCL will cancel the LPG connectionor the Refills can be taken at Non Subsidised rates.
14. The consumer shall pay the stamp duty, if any, in respect of the subscription voucher.
For subscription voucher only
(deposit will not be refunded without production of this document)

HP gas consumer certificate: i/we acknowledge having received from HPCL the quantity of HP gas cylinder(s) and pressure regulator(s) mentioned in the nos. Column hereof on loan on the
conditions which have been set out overleaf and by which i/we agree to abide. I/we have also received the HP gas instruction card.
HP gas distributor’s certificate: received on behalf of Hindustan petroleum corporation ltd., the amount mentioned above being the deposit of HP gas cylinder(s) and pressure regulator(s) loan
in accordance with company’s tariff
For termination voucher only
HP gas consumer’s certificate: I/we declare that i/we have received the amount as mentioned above being the balance of the amount of deposit to my/our credit in accordance with the
conductors of supply. HP gas distributor’s certificate: equipment received in good condition. This TV is valid for one year
REMARKS: Regulator Serial No. :d965745. Quota consumed for FY 2024-2025:2/12,Impressed Fund Amt.Collected Rs 0.00,Transfer to : BHUBANESHWAR

DATE DEALER’S SIGNATURE TO BE SIGNED IN PRESENCE OF EACH OTHER DATE CONSUMER SIGNATURE