This is a reference format, not legal advice. Individual distributors (Indane, HP Gas, Bharat Gas) may ask for their own specific form alongside or instead of this - check with your distributor before submitting.
When You Need This
LPG distributors commonly ask for a self-declaration affidavit for a new connection, for transferring an existing connection's name between family members, or for reporting a lost subscription voucher/booklet. Pick the situation that matches yours below.
Enter Your Details
Pick your situation and fill in the connection details - we'll generate a properly worded affidavit below.
Click anywhere in the document above to fine-tune the wording before printing, and add your signature below.
← Edit DetailsHow to Use This Format
- Generate the document, then use "Add Signature" to draw or upload your signature.
- For a name transfer, the existing consumer (your parent/family member) may also need to sign the distributor's own transfer form alongside this affidavit.
- Check whether your distributor wants this notarized/on stamp paper, or accepts a plain self-declaration.
Frequently Asked Questions
It covers three common situations - a self-declaration for a new connection (similar in intent to the distributor's own Annexure I), transferring an existing connection's name between family members, and declaring a lost subscription voucher/book.
Some distributors accept a self-declaration affidavit as supporting evidence when you can't immediately furnish standard address proof, alongside whatever alternate ID you do have - but this is at the distributor's discretion. Confirm with your specific distributor first.
This varies by state - many distributors accept a plain self-declaration without stamp paper for routine matters, while some ask for Rs. 20-Rs. 100 stamp paper for name transfers. Confirm with your specific distributor before printing.
This typically needs a joint declaration - the existing consumer confirming they're transferring the connection, and you confirming you're taking it over - along with ID/address proof and the distributor's own transfer form. This affidavit supports that declaration.