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Request for Transfer of Gas Connection

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Present Owner
Consumer No/ Account ID :*
12345678901
:کنزیومر نمبر/ اکائونٹ آئی ڈی
Name & Address نام اور پتہ
 
New Owner Bio Data
Name (for transfer of gas connection) :* : نام جس پر کنکشن منتقل کرنا ہے
CNIC No: *
12345-1234567-1
:کمپیوٹرائزڈ قومی شناختی کارڈ
CNIC Issuance Date: *
15/01/2020
:قومی شناختی کارڈ کی تاریخ اجراء
Mobile: *
0321-4549525
:موبائل
Telephone:
0423-1234567
:ٹیلیفون
Email: *
youremail@example.com.pk
: ای میل
You are : *                :آپ ہیں
Captcha Image :*
Type characters as shown in below box.
: Captcha تصویر
All fields marked with * are mandatory.