Gujarat Gas Company Ltd. - Domestic Request

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Home > Customers > DOM-RES Customer Registration Process > Domestic Connection Request - Form

Expression Of Interest For Gas Connection [For Domestic Customers]

English Gujarati

Field mark with [ * ] are required

Name *

Father/Husband's Name *

Surname *

Date Of Birth *

Gender

OwnerShip Type

OwnerRented

No.of Family Members

House Type

Name Of House

Flat/House No *

Floor

Plot No

Name Of Apt./Building *

Society Name *

Street/Road Name

Area *

LandMark *

Name Of City *

Pincode

Mobile No.-Owner *

Alternate No.

Contact Person Name *

Contact Person Mobile No.*

Rental Person Name

Rental Person Mobile No

Average Electricity Bill. *

GeySer Point

YesNo

Kitchen Point

Occupation

Email Address *

Note

DISCLAIMER

THE APPLICATION FORM/EXPRESSION OF INTEREST FOR A PIPED NATURAL GAS CONNECTION FOR HOUSEHOLD PURPOSE shall not be deemed or construed to be an offer capable of acceptance and nothing stated herein shall be deemed or construed to be either a promise, implied or express, or the acceptance of any terms and conditions by Gujarat Gas Company Limited. This does not in any manner impose any legal obligations on GGCL or confer any rights on any other party in respect of the contents herein and no party shall be entitled to rely on this document for entering into contractual obligations with GGCL or any third parties by virtue of this document. Any contractual obligations or rights which may arise in respect of the contents of this document shall always be subject to a final and binding written contract executed between GGCL and the party claiming such contractual obligations or rights, signed on behalf of GGCL by an authorized signatory of GGCL after obtaining all necessary GGCL internal approvals in that regard.

THE ABOVE APPLICATION FORM/EXPRESSION OF INTEREST FOR A PIPED NATURAL GAS CONNECTION FOR HOUSEHOLD PURPOSE MAY BE REJECTED AFTER EVALUATION OF THE DOCUMENTS SUBMITTED AT THE TIME OF BOOKING

GUJARAT GAS COMPANY LTD.

Adajan Gam Post Box No :915,P.O. Navyug College, Surat-395009, India Tel: +91-261-2736373,2736333 Fax: +91-0261-2736362

Surti Bhagol, Umarwada Road, Via Parimal Naka, Ankleshwar -393001, Tel: +91-2646-246121-22-23

Sontalavadi, Anand Mangal Society, Bharuch -392001, Tel +91-2642-243352-53-54

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