__________ (Gas Connection Distributor Name)
__________ (Gas Connection Distributor Address)

Date: __/__/____

Subject: Application for Gas Connection Address Change


I, _______________ (Applicant Name), son of/ daughter of/ wife of _______________ residing at __________ ( Address) having a _______ (LPG/PNG) connection in the name of _________ (Connection Holder Name) having customer Identification Number ___________ (CIF ID). I have shifted to _____________________ (new address).

I request you to kindly update my address ________ (new adsdress) in gas connection having customer Identification Number ___________ (CIF ID) for any future communication and delivery purposes.

I am enclosing _________ (undertaking/gas connection amendment form/KYC documents) along with the application.

Thank you,

Signature: _____________
Your Name: __________
Mobile number: _________

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