Oorja Shakti

Grievance Submission Form

Application for Redressal of Grievance

Note: * Indicates Required Fields

Date *

Full Name *

Address *

Email *

Phone Number *

PIN Code *

Fax Number *

Nature of Connection and Consumer No. *

(In case of having applied for a connection, state the application number)

Distribution Licensee *

Complaint Receiving Centre Number *

Categories of Grievance *

Details of the Grievance *

Nature of Relief Sought *

Upload Documents *

Declaration

I/We, the Complainant(s), declare that:

The information furnished herein is true and correct.
I/We have not concealed or misrepresented any facts stated herein and the documents submitted.

The subject matter of the present grievance has not been previously submitted to the Forum by me/us or any concerned parties to the best of my/our knowledge.

The subject matter of the present grievance has not been settled through the Forum in any previous proceedings.

The subject matter of my/our grievance has not been decided by any competent authority/court/arbitrator and is not pending before any such authority.

Nomination *

(If you wish to nominate a representative to appear and make submissions on your behalf before the Forum, please complete the following.) I/We, the above-named consumer, hereby nominate whose address is as my/our REPRESENTATIVE in the proceedings. I/We confirm that any statement, acceptance, or rejection made by him/her shall be binding on me/us. He/She has signed below in my presence.

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A. Grievance Redressal from Local Office

Section Office

Sub Divisional Office

Divisional Level Complaint

Circle Level Complaint

Zonal/Area Level Complaint

HQ Level Grievance

Grievance Submission Form

Application for Redressal of Grievance

Declaration

Nomination *

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