Apply New PNG Connection

City*

Scheme Name* Please choose your desired scheme.

Customer Name* Name Matches with your identity proof

Father's/Husband's Name*

Date of Birth*

Mobile* Enter a valid 10-digit mobile number.

Landline

Email*

Verify your email before submitting the form.

House No.

Area*

Sub Area*

Society

Street

Landmark

State*

Pincode*

Ownership*

House Type*

House Block

House Floor*

Do you have LPG Connection?*

LPG Consumer Number

LPG Provider Name*

Select Identity Proof:* Select the type of ID you want to provide.

Enter ID Number:*

Upload ID Front: Allowed file types: .jpg, .png. Maximum file size: 100 KB.

Upload ID Back: Allowed file types: .jpg, .png. Maximum file size: 100 KB.

Select Proof of Address

Upload Address Proof: Allowed file types: .jpg, .png. Maximum file size: 100 KB.