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ST. KITTS ELECTRICITY COMPANY LIMITED (SKELEC) APPLICATION FOR ELECTRICITY SUPPLY Form No.
Owner TenantNAME:
ADDRESS WHERE SUPPLY REQUIRED
POSTAL ADDRESS
TEL: FAX:
Meter #:
Residential Industrial Government
PREVIOUS OCCUPANT:
TYPE OF OCCUPANCY:
Total floor area sq ft.
Yes No
Supply Required: Overhead Underground (Single phase 2 wires) 3 phase 4 Wires
Size of main switch No. Of circuits
(a) Lighting kW (e) A/C Motors HP phase
(b) Water Heating kW (f) Washer
(c) Electric Cooker kW (g) Dryer
(d) Microwave kW
(h) Other loads or motors
Date Supply required
Date available for inspection (new installations)by Inspector
Date available for test (new installations)by Skelec
Does Applicant already receive electricity supply elsewhere? Yes No
If Yes, give address and account No
I/We make application for electricity supply by the above premises and agree:- i. To pay for electricity consumed monthly, in accordance with rates and tariffs set by the St. Kitts Electricity Company Limited (SKELEC) from time to time.
ii. To deposit with SKELEC an amount, which said sum shall be called a "security deposit" in the case of rented premises and in such amount as shall be deemedapplicable by the St. Kitts Electricity Company Limited.
iii. To be bound by the St. Christopher (Electricity Supply) act 2011 and by all Regulations made there under.
Date Signature
Signature:
Signature of Owner/Agent (if
property rented)
Name and Address of Electrician
Tel # of Electrician:
Application accepted by for St. Kitts Electricity Company Limited. Date
Owner by Agent
Name of Owner/Agent
Upgrade Amount
Signature of CSR
Security Deposit required (if applicable)Security Deposit will be reviewed and upgraded after 3 months if necessary
05/14/2014 Page 1 of 5
ST. KITTS ELECTRICITY COMPANY LIMITED (SKELEC) APPLICATION FOR ELECTRICITY SUPPLY
For Office use only
NAME Owner Tenant
1) To Metering & Connections
Please provide estimate of cost for providing an electricity supply.
Consumer Clerk Date
2) To Consumer Clerks
(a) Estimate attached in amount of $
(b) Supply cannot be provided for the following reasons:-
for metering & Connections Section Date
3. Estimate cost of Service advised to prospective customer (date) by letter/
telephone/verbally.
CSR Name Date:
4) Estimate paid (Date) (Receipt No)
(Date)Deposit paid
Inspection of Premises Approved: Form #
(Deposit)
CSR
Date
Metering and Connections Service Order # Date:
Date: Connection Completed:
5) (Date)
Date
Account uploaded
Service Location
Security Deposit Ledger updated
Account #:
(date)
Name of CSR
Date:CSR Signature:
Consumer Services Supervisor/Mgr Date:
Documents Required
Tenant: Photo ID:
Land Lord: Photo ID:
Agent: Photo ID:
Proof of Ownership
Power of Attorney
Temporary Connections: Commencement Certificate:
Commercial Customers Only: Business Licence #:
CSR Signature
Owner by Agent
Permanent Connections: Certificate of Occupancy
05/14/2014 Page 2 of 5
(Receipt No)
ST. KITTS ELECTRICITY COMPANY LIMITED (SKELEC)
APPLICATION FOR ELECTRICITY SUPPLY For office use only
Owner Tenant
Residential
(Home) (Other)
Meter No.:
(H) (M)
Meter No. :
Date:
Name:
Opening Reading
Service Address:
E-mail address:
Tel. No.
Fax: No
Previous Tenant (if applicable):
Name:
Address:
E-mail address:
Tel. No. (B)
Fax: No
CSR Signature:
Entered by: Signature:
Closing Reading
Owner by Agent
Type of Occupancy
Commercial
Please add consumer to Billing system
CSR Name
Existing account # (if applicable)
Service Order #
Service Order #
New Account No:
Postal Address
Date:
Account #
Industrial Government
05/14/2014 Page 3 of 5
Date
Remarks
PAYMENT FOR NEW SUPPLYMonth / Day / Year
Name / Business Name:
Address:
Application Form #: Cashier Initials Date: Receipt#:
Receipt Control No:
Amount
----------------------------------------------------------------------------------------------------------------------------------------------
PAYMENT FOR NEW SUPPLYMonth / Day / Year
Name / Business Name:
Address:
Application Form #: Cashier Initials Date: Receipt#:
Receipt Control No:
Amount
PAYMENT FOR NEW SUPPLYMonth / Day / Year
Name / Business Name:
Address:
Application Form #: Cashier Initials Date: Receipt#:
Receipt Control No:
Amount
----------------------------------------------------------------------------------------------------------------------------------------------
NS
NS
NS
05/14/2014 Page 4 of 5
PAYMENT FOR SECURITY DEPOSITMonth / Day / Year
Name / Business Name:
Address:
Application Form #: Cashier Initials Date: Receipt#:
Receipt Control No:
Amount
----------------------------------------------------------------------------------------------------------------------------------------------
PAYMENT FOR SECURITY DEPOSITMonth / Day / Year
Name / Business Name:
Address:
Application Form #: Cashier Initials Date: Receipt#:
Receipt Control No:
Amount
PAYMENT FOR SECURITY DEPOSITMonth / Day / Year
Name / Business Name:
Address:
Application Form #: Cashier Initials Date: Receipt#:
Receipt Control No:
Amount
----------------------------------------------------------------------------------------------------------------------------------------------
SD
SD
SD
05/14/2014 Page 5 of 5