Application for Electrical Contractor's License
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(*) Asterisk marked fields are mandatory
1. Name of firm in which an Electrical Contractor's License is applied*
2.a. Business address (as specified in GST Registration)
2.b. Business Phone No.
2.c. Business Email
3. Whether the license is sought for:*
Proprietary
Company
Partnership Firm
4. In case of company/partnership firm, whether authorisation letter for Authorised Signatory is enclosed in Form A3*
Yes
5. Full name of the Proprietor/Authorised Signatory*
6. Applicant's Father's Name*
7. Home Address same as business address?
Yes
7.a. Home Address
7.b. Home phone number
7.c. Home EmailID
8. Date of Birth (DD/MM/YYYY)*
Day
Month
Year
9. Indigenous Inhabitant of Nagaland/ ST Certificate issued after 2.02.2016*
Yes
No
10. Class of License applied for*
Class I (Exceeding 33 kV)
Class I(Not exceeding 33 kV)
Class II (Not exceeding 650 V)
Class II (Not exceeding 250 kV)
11. Previous License No. (if any)
12. No. of Supervisors employed*
-
+
13. No. of Workmen employed*
-
+
14.a. Initial Fee payment*
14.b. Challan No.*
14.c. Challan Date*
15. List of instruments maintained by the applicant furnished in Form A1*
Yes
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