indane gas new connection form

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Distributor Name: (To be filled by consumer while registering for LPG Gas connection) Particulars Please write correct details as given in documents Paste your photo here Name of Consumer* Salutation
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Comments and Help with gas form

If house has been recently sold if you do not have an image of your house or house address, leave blank Please write your full name as given in document and copy it in this field Please write your contact number Phone Number (required) I confirm that: I am 18 years of age or above I have my ID proof (i.e. Passport, Birth Certificate, etc.) in my possession I am a resident of the same district and district number as given on the registration I am a resident of a municipality whose official telephone number is available on the notification document (Note: Municipal Telephone Number is only for registered customers) I know the type and quantity of fuel I am purchasing I am a resident of the country where the delivery point is located and where gas connections and gas cylinders are installed. No. of people in delivery/purchasing group No? Please choose your choice of people in the delivery/purchasing group 1-2 people 3-4 people 5-6 people 7 people 8 people 9 people 10 people Other. Note: A list of registered customers can be obtained by the Customer Care Center by presenting these documents at any time for further questions.
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