CSMC

छत्रपती संभाजीनगर महानगरपालिका

Right to Services

CSMC

Application Form For Permanent Disconnection
(कायमस्वरूपी नळ जोडणी खंडित करणे अर्ज)

Application Form Details (अर्ज तपशील)

Consumer Number. (ग्राहक क्रमांक)*

Please Enter Valid CAN No.

Zone No.(झोन क्र.)*

Please Enter Valid Zone No.

Consumer Name (ग्राहकाचे नाव)*

Please Enter Valid Consumer Name.

Tap Size in inch(टॅपचा आकार)*

Please Enter Valid Tap Size.

Usage Type (वापर प्रकार)*

Please Enter Valid Category.

Consumer Address (ग्राहक पत्ता)*

Please Enter Valid Consumer Address.

Consumer Email Id (ग्राहकाचे ई - मेल आयडी)*

Please Enter Valid Email Id.

Consumer Mobile No. (ग्राहकाचे मोबाईल क्र.)*

Please Enter Valid Mobile No.

Disconnection (नळजोडणी खंडित करणे)*

Permanent (कायमस्वरूपी)

List of Documents (with attachment) (दस्तऐवजांची यादी (सह संलग्नक))

Note (नोंद): Upload below files only pdf, .jpg, .jpeg, .bmp (Max upto 5 MB)(खाली फक्त pdf, .jpg, .jpeg, .bmp फाइल अपलोड करा (कमाल ५MB पर्यंत))

Download Pdf For Reason

Self-Attested Applicant's ID Proof (स्वयं-साक्षांकित अर्जदाराचा आयडी पुरावा)*

File selected is either greater than 5Mb or not of type .pdf.

Copy Of Address/Ownership Proof/Tax Receipt (पत्त्याची प्रत/मालकीचा पुरावा/कर पावती)

File selected is either greater than 5Mb or not of type .pdf.

Current Year Paid Receipt (चालू वर्षाची देय पावती)*

File selected is either greater than 5Mb or not of type .pdf.

Upload Pdf (Reason of Disconnection)*

File selected is either greater than 5Mb or not of type .pdf.

Declaration (घोषणा)*:- The above mentioned information is true to the best of my knowledge and belief (वर नमूद केलेली माहिती माझ्या माहितीनुसार आणि विश्वासानुसार खरी आहे).

Please check the declaration.

छत्रपती संभाजीनगर महानगरपालिका

Right to Services

Application Form For Permanent Disconnection (कायमस्वरूपी नळ जोडणी खंडित करणे अर्ज)

Application Form Details (अर्ज तपशील)

List of Documents (with attachment) (दस्तऐवजांची यादी (सह संलग्नक))

Note : Upload listed files only .pdf, .jpg, .jpeg, .bmp (Max upto 5 MB)

Application Form For Permanent Disconnection
(कायमस्वरूपी नळ जोडणी खंडित करणे अर्ज)