Schedule – 9
(Related with Sub-rule (3) of Rule 15)
Format of the Application to Be Submitted for Review
Application of Review
Submitted to the Office of …………………
To,
The ……………… (Name of Office of Distributor)
Address
C/o
The Investigating Officer
………………… (Name of the Concerned Office)

Upon making investigation and inquiry into the house or building used by  me/us, as per information of the offence received by that Office pursuant to the Electricity Leakage Control Act, 2058 (2001) and the Electricity Leakage Control Rules, 2059 (2002), it was evaluated that I/we have stolen the electricity worth Rs. ……… with the charge that the offence of stealing electricity is being committed is going to be committed. Notice was given to me/us on …………… to pay total Rs. ………… comprising of Rs. ………… for loss and damage, Rs. …………… for compensation and Rs.
………… for re-connection of electrical line and I/we am/are not satisfied with this notice. Now, therefore, I/we have hereby submitted this application for review of the  order so issued by the Investigating Officer pursuant to Section 13 of the Electricity Leakage Control Act, 2058 (2001) and Rule 15 of the Electricity Leakage Control
Rules, 2059 (2002).

My claim petition is as follows:
1.
2.
3.
4.
Supporting documents
1.
2.
3.
4.
The content mentioned herein is true and correct. In case it is proved to be false, I/we
shall pay and bear as per the laws.
Applicant’s:-
Signature:-
Date:-
Full name and surname:-
Address:-