THIS FORM IS NOT FOR SALE

ENUGU ELECTRICITY DISTRIBUTION COMPANY

(FOR OFFICIAL USE) APPLICATION NO.: DATE:

APPLICATION FOR ELECTRICITY SUPPLY AND AGREEMENT FORM

(TO BE COMPLETED IN DUPLICATE BY THE APPLICANT AFTER STUDYING THE CONDITIONS
AND REGULATIONS OF SUPPLY SPECIFIED OVERLEAF)

ATTACH
PART 1: CUSTOMER PERSONAL DATA APPLICANT
PASSPORT
1.1 APPLICANT’S SURNAME: (MR/MRS/MISS/M/S)
PHOTOGRAPH
OTHER NAMES IN FULL:

1.2 ADDRESS AT WHICH SUPPLY IS REQUIRED: HOUSE NO:

BUS STOP

LANDMARK LGA PIN CODE:

1.3 TYPE OF PREMISES

Duplex 3BD Room Flat 2BD Room Flat Single Room Block of Flats Tenement House

Boys Qtrs. Shop Individual Others (Please Specify)

1.4 USE OF THE PREMISES

Residential Commercial Industrial Street Light Special (Please Specify)

PREVIOUS DETAILS (If applicable)

(A) CUSTOMER ADDRESS:

(B) ACCOUNT No.: METER No.: District:

1.5 NAME OF EMPLOYER/BUSINESS:

ADDRESS OF EMPLOYER/BUSINESS:

LANDMARK LGA PIN CODE:

1.6 CONTACT TEL NO(s): Mobile NO(s):

1.7 EMAIL:

1.8 VALID MEANS OF IDENTIFICATION: International Passport Driver’s License PVC

1.9 PERSONAL IDENTIFICATION NO. (International Passport, Driver’s License, PVC):

PART 2: DECLARATION
(TO BE COMPLETED BY CERTIFIED/REGISTERED ELECTRICAL ENGINEER/ACCREDITED ELECTRICAL CONTRACTOR)
2.1 LOAD REQUIREMENT FOR THE PREMISES:
No . Wattage No. Wattage
A. Light Point J. TV
B. Ceiling Fan K. Pumping Machine
C. Socket outlets – 13 Amps L. Refrigirator
15 Amps M. Washing Machine
D. Cooker N. Microwave
E. Water Heater O. Toaster
F. Air Condition P. Electric Kettle
G. Freezer Q. Machinery
H. Dispenser R. Single Phase Motor (Watts)
I. Pressing Iron T. Three Phase Motor (Watts)
*Details of Additional Equipment can be attached separately.
Total Installed load Watts

2.2 REQUESTED VOLTAGE: 33KV 11KV 0.4KV TYPE OF SUPPLY: 1 Phase 3 Phase
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2.3 NAME OF THE REGISTERED ELECTRICAL ENGINEER/ELECTRICAL CONTRACTOR

ADDRESS

LICENSE NO CATEGORY
SIGNATURE DATE

2.4 NATURE OF PROPERTY: OLD NEW

2.5 TYPE OF PROPERTY: SINGLE HOUSE APARTMENT TERRACE PUMP HOUSE

OTHERS (Please explain):

2.6 DOES THE PROPERTY HAVE PLANNING PERMISSION: YES NO

2.7 DOES THE PROPERTY HAVE A METER: YES NO

2.7.1. IF PROPERTY HAS A METER

2.7.2. METER No.: 2.7.3. CUSTOMER ACCOUNT No.:

2.7.4. METER TYPE AT PROPERTY: PRE-PAYMENT POST PAID METER MAXIMUM DEMAND

2.8 ESTIMATED MAXIMUM LOAD FOR Amperes per phase

2.9 TO BE COMPLETED BY ONLY THOSE REQUESTING FOR CHANGE OF CUSTOMER CLASS

METER NUMBER ACCOUNT NUMBER

I/WE HEREBY REQUEST THE ENUGU ELECTRICITY DISTRIBUTION COMPANY TO SUPPLY US WITH ELECTRICITY AT THE ADDRESS STATED AT
THE 1.2 ABOVE FOR THE PURPOSE STATED IN 1.4 ABOVE AND AGREE TO PAY ALL CHARGES MADE BY EEDC IN ACCORDANCE WITH THE
PREVAILING EEDC TARIFF OF SUPPLY AS APPROVED BY NIGERIAN ELECTRICITY REGULATORY COMMISSION (NERC).

I/WE CONFIRM THAT THE INFORMATION GIVEN IN PART 1 ABOVE IS TRUE IN ITS ENTIRETY AND AGREE THAT IF ANY PART OF IT IS FOUND
TO BE UNTRUE THE ELECTRICITY SUPPLY MAY BE DISCONTINUED.
APPLICANT’S SIGNATURE DATE

PART 3: TO BE COMPLETED BY OWNER OF PREMISES (LANDLORD)

3.1 SURNAME (MR/MRS/MISS/M/S) 3.2 OTHER NAMES IN FULL

3.3 DATE OF BIRTH

3.4 CONTACT TEL/MOBILE NO.: 3.5 EMAIL ADDRESS

3.6 NAME OF EMPLOYER/BUSINESS:

ADDRESS OF EMPLOYER/BUSINESS:

3.7 METER NUMBER

CUSTOMER ACCOUNT NUMBER (FOR PREMISES)

3.8 PERSONAL IDENTIFICATION NUMBER (International Passport Driver’s License PVC )

I confirm that the Applicant is my tenant and certify his/her request for electricity supply and also accept to notify EEDC in writing when
he/she gives notice (in writing or otherwise) of termination of his/her tenancy agreement, failing which any outstanding debt or dues on
his/her account may be debited to my own account.
SIGNATURE DATE

ACKNOWLEDGEMENT
CUSTOMER NAME: APPLICATION NO.:

ADDRESS: DISTRICT.:

NAME OF OFFICER:

SIGNATURE DATE
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PART 4 FOR OFFICIAL USE ONLY
(A) TO BE COMPLETED BY COMMERCIAL OFFICER
TYPE OF APPLICATION TICK TYPE OF APPLICATION TICK
I. NEW SERVICE VI. CONVERSION FROM SINGLE PHASE TO
II. ADDITIONAL LOAD/REPRODUCTION THREE PHASE to MD Meter
III. CHANGE OF CUSTOMER
VII. IS PROPERTY EARTHED?
IV. ADDITIONAL METER
V. CHANGE OF TARIFF VIII. PLANNING PERMISSION (NEW PROPERTY)

4.1 FOR EXTENSION/REDUCTION OF LOAD/CHARGE

EXISTING LOAD KWH
ADDITIONAL/REDUCTION LOAD KWH
TOTAL LOAD KWH

4.2 CUSTOMERS PREFERENCE/PREFERRED METHOD OF PAYMENT: CHEQUE ATM POS ONLINE CASH DEPOSIT

4.3 PREFERRED METHOD OF RECEIVING BILLS: BILLS DELIVERY TO THE HOUSE BILLS SENT BY EMAIL BILLS SENT BY SMS
These services will commence soon.
4.4 CUSTOMER IDENTIFICATION NO (CIN):

4.5 GPS COORDINATE:

REMARK/RECOMMENDATION:

THE ORIGINAL OF THIS APPLICATION HAS BEEN RECEIVED BY:

SIGNATURE DESIGNATION: DATE

(B) TO BE COMPLETED BY METER SUPERVISOR

METER NO: ACCOUNT NO:

METER READING ON THE LAST BILL:

FINAL METER READING ON (DATE): IS

SIGNATURE DATE

NAME: DESIGNATION:
(C) TO BE COMPLETED BY CREDIT CONTROL SECTION

THE LATEST BILL ON THE ACCOUNT IS: (MONTH) (AMOUNT)

THE OUTSTANDING IS N FINAL BILL AS PER PART (B) ABOVE IS N

THE TOTAL NOW DUE OF N FINAL VIDE EEDC MACHINE RECEIPT NO.:

(I) WAS SETTLED ON (DATE) FINAL VIDE EEDC MACHINE RECEIPT NO.:

OF (DATE)
(II) N HAS NOT BEEN SETTLED BUT TRANSFERRED TO ACCOUNT OF

ACCOUNT NO.: METER NO.:

NAME: ADDRESS:

THE APPLICATION IS HEREBY CLEARED FOR FURTHER PROCESSING

SIGNATURE: DATE:

NAME: DESIGNATION:

(D) FINAL APPROVAL

CHECKED BY: NAME: DESIGNATION:
SIGNATURE: DATE:

APPROVED BY: NAME: DESIGNATION:

SIGNATURE: DATE:

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PART 5: CONDITIONS AND REGULATIONS OF SUPPLY

I/We hereby request that Electricity will be supplied in accordance with the Electricity
Power Sector Reform Act 2005of the Federal Government of Nigeria and all the relevant Codes and Regulations as approved by the Nigerian Electricity
Regulatory Commission (NERC).

The EEDC (thereinafter called “The Operator”) will supply Electricity subject to the following terms and conditions.
1. SYSTEM OF SUPPLY
The Operator’s system is alternating Current at a frequency of 50 Hertz. The medium Voltage will be either 230 Volts single phase or 400 Volts three phase.

2. INSTALLATIONS
Wiring installation shall be executed to the satisfaction of the Operator which will inspect and/or test installation.

3. SERVICE LINE
The nature and location of service lines and other supply facilities shall be determined by the Operator. The Operator shall be at liberty at any time to take branch
services off the service lines whether on the customer premises or not, for the purpose of supplying electricity to any other premises. The customer shall obtain all
facilities required by the Operator for the installation of the service line including the necessary Right of Way over his own and/or adjacent property which the
Operator may require. Any service line or other facilities provided by or donated by a consumer shall be treated in line with the Investment in Networks Regulation
by the Commission.

4. ACCESS TO PREMISES
The customer shall give the Operator all reasonable and necessary access to the customer’s premises for the purpose of connecting, disconnecting, inspecting,
testing, altering, replacing, maintaining or removing any service line, meter and/or other apparatus or any part thereto and for reading the meter. The Operator’s
official will produce the Operator identity card, upon demand. The Customers shall pay a fee for each special meter reading made on request.

5. ADDITIONAL EQUIPMENT
After the installation referred to in schedule 2.1 hereof has been tested and passed by the Operator, the customer shall not have any additional equipment
connected to his installation without submitting an application form EEDC 74 to the Operator giving at least seven days notice of his intention to do so,
and he shall not use such additional equipment until the installation has been re-tested and passed by the Operator. Neglect of this precaution may cause
interruption of supply and damage to EEDC Equipment. A penalty may be imposed for default.

6. TESTING AND ACCURACY OF METERS

Should the customer or the Operator gives notice disputing the accuracy of a meter, such meter shall be tested by the Nigerian Electricity Management Services
Agency (NEMSA). If the Customer considers his meter inaccurate, his notice to that effect shall be accompanied by a deposit to cover the cost of the test. In the
event of the meter having an error exceeding the line of error as may be allowed by the regulation in force, the amount payable for electricity charge for the period
for which the customer is charged on the last invoice rendered prior to the notice of dispute shall be determined in line with the provisions of NERC’s Regulation
on Meter Reading, Billing, Cash Collection and Credit Management.

7. DISCONTINUANCE OF SUPPLY
Not less than seven days notice in writing must be given to the Operator by the Customer or landlord before vacating the premises. In default of such notice the
Customer shall be liable to the Operator for all accounts arising until such notice is received or until the Operator accepts an application for the supply to the same
installation from another Customer.
The Operator reserves the right to discontinue supply of electricity for purposes of safety, when other Customers are being connected or when the Operator’s
mains or equipment are being tested, repaired, or in cases of unavoidable interruption due to fire, flood, tempest, accident and breakdown of machinery.

8. PAYMENT FOR ELECTRICITY SUPPLY

From the date supply is made available, the Customer must pay monthly for all electricity billed in accordance with the applicable rate. Official Receipts are issued
by the Operator for all payment made to it. Customers are advised on each occasion to check that the amount on their receipt corresponds with the sum paid.

SPECIAL NOTE:
Whenever any customer of electricity supplied by the Operator leaves the premises where such electricity has been supplied to him without paying the charges
for electricity or meter rental due to him, the Operator shall be entitled to recover from the Landlord in accordance with Clause 3.9.

9. RESPONSIBILITY FOR EEDC APPARATUS

The Customer shall ensure the safety against damage or destruction by fire and shall be solely responsible for the safe custody of the meter and other
apparatus belonging to the Operator that were installed at his premises and shall not damage, alter, remove the same or obliterate or remove any
marks, words, or numbers thereon, or permit any such damage. The Customer shall make good any such damage or reimburse the Operator to
the extent of any loss the Operator may sustain by reason of any breach of these conditions and regulations. The customer shall give notice to the
Operator of any breakdown, failure, loss, injury, or damage to the meter or any apparatus belonging to the Operator installed in his premises.

10. NON-LIABILITY OF OPERATOR

The Operator will not be responsible for any loss or damage occasioned to any person or Property whether belonging to the customer or not arising
out of any defects in or accident to the wiring installation or by the use of the electricity supplied or any apparatus that belongs to the Operator or
through any default arising on the Operator’s system or for any cause beyond their control. This provision is subject to the operator putting in place
all safety measures to ensure a duty of care in the discharge of its responsibility to the customer.

11. THE IMPROPER USE OF SUPPLY

If the customer makes use of the supply in such a way as to interfere with the general distribution of the electricity, immediate steps shall be taken to
remedy the defect complained of or supply discontinued.

12. BREACH OF AGREEMENT

If the customer shall neglect or refuse to pay the electricity supplied in accordance with these conditions and regulations, or become subject under
the bankruptcy laws or enter into liquidation, or suffer execution to be made on his effects or commit any other breach of this agreement, the Operator
may terminate this agreement and/or discontinue the supply ofelectricity and/or remove the apparatus belonging to them subject to the provisions of
NERC’s Regulation on Connection and Disconnection of Electricity Services.

13. REVISION OF CONDITIONS OF SUPPLY.

The Operator may from time to time, on giving notice to the customer in writing or by public notice amend or alter any of the above conditions of supply
or their scale of charges and such amendment or alterations shall take effect from the date specified in the said notice as approved by NERC.

14. The customer and the operator also hereby agree to abide by and exhaust all administrative remedies as contained in the NERC Customer Complaint
Handling and Procedures Regulations before resorting to any other dispute resolution or adjudicatory process.

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