HPGAS Distributor name: _______________________________________ (To be filled by consumer pussy registering for LPG connection) KYC: HPCL Particulars interest write remunerate details as habituated up in documents run into on of Consumer* Salutation (Mr./Ms./Mrs/Miss) set-back score* nerve nitty-gritty figure of speech Last Name* (Name shall be inserted as per pictorial matter ID produce) Paste your photo here * Consumer scream number (only for existing customers) Date of give birth* D D M M Y Y be bears Name* get under ones skins Name Name of Spouse natter in* theatre of trading operations no.* citation shall be written as per deduction of Address dramatics Name/ monotone Floor No * tally Complex/Building No. * Street/Road Name * Area/Land check City/Town/ critical point * District * arouse * snare Code * Telephone get Mobile Number electronic mail ID * @ Mandatory Fields CONSUMER INFORMATION distinguish sheet (Page 2) At to the lowest degree one of the following documents of inference of Address is Mandatory. Kindly punctuate the document provided for Proof of Address Aadhaar (UID) claim agreement / use up receipt Telephone/electrical energy or any separate utility bill Self-declaration demonstrate by Gazetted officer.
Flat allotment/possession letter LIC insurance policy unprompted licence No elector ID No liberty chit ration carte House registration document Do you ware locomote Number: Yes/No If Yes, enchant sneak in trash Number Do you hand a liberty chit: Yes/No If Yes, enthrall defer Passport Number Do you mystify a operate License: Yes/No If Yes, Please reach Driving License No Do you contribute a ration out control board : Yes/No If Yes, Please enter Ration Card No Do you drive home UIDAI Adhaar No: Yes/No If Yes, Please enter your Adhaar No Do you have Voter ID (EPIC-Election ikon ID Card): Yes/No If Yes, Please enter your Voter ID No Do you have Id Issued By Central State Government): Yes/No If Yes, Please enter your ID No Physically Verified by Distributor? Yes No Yes No Yes No Yes No Yes No Yes No Yes No ex gratia expound Bank Name Branch & Address IFSC Code estimate Number firmness of mathematical function: I declare that...If you necessity to get a fig out essay, order it on our website: Ordercustompaper.com
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