ENQUIRY FOR SUPPLY OF ELECTRICITY
Date: Customer Application Number:
APPLICANT’S SECTION
1. TYPE OF APPLICATION – Tick where applicable
Premium Application (above 25kVA) Standard Application (below 25 kVA)
Type of Application:
New
Temporary
Rerouting
Group Application
Meter Separation
Account No.:
Additional Load
Account No.:
No. of Meters Required:
Note: Attach copy of latest bill for additional load and meter seperation applications
TO DOWNLOAD FORM IN PDF, CLICK HERE.
2. APPLICANT’S DATA
Surname/Company Name: First Name: Middle Name:
ID/Passport No.: County of residence: P.O. Box:
Postal Code:
Town of residence:
Mobile Tel No.(s): Office Tel No.:
Customer’s email address:
Customer Contact Person: Self Other Name:
Telephone/Mobile:
3. SUPPLY LOCATION DATA
County: District: Division:
Sub-location: Street: Village/Estate:
Name/House No: LRN/Plot No.:
4. APPLIANCES
(A) FIXED APPLIANCES
(Cookers, Heaters, Air conditioners, Fridges, Ovens,
etc.)
(B) PLUG
POINTS (Socket
outlets)
(C) MOTORS
Type No. kW Amp
13 Amps
15 Amps
20 Amps
No. No. Phases HP or kVA Purpose for which
required
(D) Lighting Points (Bulbs)
No.:
(E) OTHER APPARATUS
Note: Please attach a separate list if the above space is not adequate
THIS FORM IS NOT FOR SALE
5. WAYLEAVES APPROVAL/CONSENT
I/We ……………………………………………………………………………………………………………… being the proprietor of parcel of land comprised in
Title No ……………………………….………………………………………………………………………… hereby consent to The Kenya Power laying or erecting an
electric supply line on my side of land and from time to time entering upon and having access to my said piece of land for the
purposes of constructing, laying, maintaining, using, removing and replacing the electric supply line.
I undertake not to interfere or permit any interference with the electric supply line nor to construct buildings, plant trees or dump
waste materials beneath the electric supply line. I also undertake that this consent shall be irrevocable.
I have supplied copies of Title deed and Land search documents as proof of ownership.
Signed by Proprietor ……………………………….…………………… Date ……………………………………………
CUSTOMER CHECKLIST: Please attach the following documents when submitting this form
All Applicants
Copy of ID
Copy of PIN Certificate
Route Sketch Map
Copy of title deed and land search documents for owner of property (to support wayleaves consent)
Supply Contract Form (signed)
Wiring Certificates
Meter Separation and Additional Load Applicant
Copy of latest Electricity Bill
Additional requirements for Premium Applicants
Scaled Site Plan (preferably in soft copy AutoCADD/DWG format)
Load Schedule Details
Applicant’s Signature: Date:
FOR OFFICIAL USE ONLY
POWER DATA
TICK WHERE APPLICABLE
ADMD** for Services
(Only to be filled if Type of Premises = Flats)
New Supply: ADMD**:
Load Increase: Supply Registration No. (S.R.N.)
No. of Supplies:
(Only to be filled if Type of Premises = Estate)
Previous ADMD**
** ADMD: After Diversity Maximum Demand
REFERENCES
ID – Identification
PIN – Personal identification Number
