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To be filled by the new occupier/user of the property stated herein below & hereby request MNGL to transfer the ownership of
PNG connection bearing BP No…………………………………. & Meter No…………………………………..
NAME OF CUSTOMER:
ADDRESS:
DECLARATION: I/We declare that whatever is stated herein above is true & correct and no information has been
concealed. If any information provided is found to be incorrect, MNGL shall be entitled to disconnect PNG supply
without any notice. I/We accept and agree the terms & conditions as amended from time to time. I/We agree to settle
the unpaid connection related charges, gas consumption bills of the previous gas consumer.
Signature of the Applicant ……………………………..…….. Date:
Name of the Applicant …………………………………… Place:
Please Provide Ownership Proof Documents- Index II copy/Latest Electricity Bill/Corporation Tax Receipt & Cheque
on Rs.250 in favor of ‘Maharashtra Natural Gas Limited’ with this form
Customer Care Office- Maharashtra Natural Gas Ltd. Flat No.1,1st Floor, 33 A Vedvati Apartment,Vimalbai Jadhav
Road, opp. Groundwater Survey office & Behind Chinar Building, Shivajinagar,Pune-411005
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FOR OFFICE USE
Remark: _________________________________________________________________________________________