New Application

Type *

First Name *

Middle Name

Last Name

Gender *

Occupation

Father's Name

House No / Building No *

Street / Lane

Locality *

Ward Number

Mobile Number *

Landline Number

DETAILS FOR WHICH CONNECTION IS APPLIED

Ownership of building *

Category of Connection *

Upload Supporting Document

Documents

Document No

Upload Document (Attested Photocopy):

Category of Building*

Name of Department*

Occupant's First Name *

Middle Name

Last Name

Occupation

Street/Lane*

Locality *

Site Office *

Landmark

Ward Number

Pincode

City/Town

Mobile No*

Landline No

No of existing connection (s) *

Materials to be provided by : *

Declaration:

a) I hereby declare that the informations furnished by me is true to the best of my knowledge and if any discrepancy is found, I will be responsible for disconnection of services by the PHED without any prior notice and any other legal action taken by PHED.
b) I will be responsible for clearance of alignment for laying of pipe.
c) I will abide by the latest Mizoram Water Tariff Act and Rules as amended from time to time.

I accept the terms and conditions of PHED Mizoram