**Sample PDF of the Affidavit is attached at the end.
Why this Declaration is Used
- This declaration is mandatory when applying for a new LPG connection from PSU Oil Companies (IOCL, BPCL, HPCL) or when taking a connection against a Termination Voucher (TV) of a previous connection.
- It ensures the one household = one LPG/piped gas connection rule is followed.
- It protects the subsidy system by preventing duplicate or fraudulent LPG connections.
When it is Used
- While applying for a first-time LPG connection.
- When shifting an LPG connection from one distributor to another using a Termination Voucher.
- When declaring no duplicate connection exists in the household.
- When furnishing KYC + Proof of Address + Proof of Identity for an LPG connection.
Purpose
- To declare that the applicant is eligible (Indian citizen or other permitted category).
- To confirm age eligibility (must be 18+).
- To declare that no other LPG or PNG connection exists in the household.
- To confirm that LPG will be used only for domestic cooking purposes.
- To agree to inform the distributor of a change of address.
- To accept that if any false info is found, the connection may be cancelled and security deposit forfeited.
FAQs
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Q1. Who has to submit this declaration?
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Any person applying for a new LPG connection or transferring an existing one through a Termination Voucher.
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Q2. Why does it ask about ration card?
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Ration cards help identify households and check for duplicate connections. If you don't have one, you must update records when you get it.
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Q3. Can a household have both LPG and PNG (piped gas)?
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No. Households with PNG connections are not eligible for subsidised LPG.
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Q4. Why is a de-duplication check done?
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Oil companies run a database check to ensure one household = one subsidised connection, avoiding subsidy misuse.
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Q5. What happens if someone hides an existing connection?
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The oil company can terminate the connection, seize the cylinder/stove, and forfeit the deposit.
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Q6. What is a Termination Voucher (TV)?
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It's a document issued when you surrender your LPG connection with one distributor, which allows you to take a new connection from another distributor.
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Q7. Is this a notarized affidavit?
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No, it is a self-declaration given to the distributor, not usually notarised.
Downloads & Resources
Legal Affidavit Document
DECLARATION
(To be submitted by persons desirous of New LPG Connection or connection against Termination Voucher)
I, ____________________________________________ son/daughter/wife of __________________________, aged ____ years, resident of __________________________________________________, desire to take a domestic LPG connection in my name and affirm as under:
- That I am an Indian citizen / Non-Resident Indian / Staff of Foreign nationality serving in India / Foreign national residing in India under a valid visa / person returning to India on a transfer of residence basis / PIO.
(Tick whichever is applicable. Only Indian citizens are eligible for subsidised LPG.) - That my date of birth is __________________ (LPG connection cannot be provided to a person under 18 years of age).
- That neither I nor any other member of the household (household means a family consisting of husband, wife, unmarried children and dependent parents living together in a dwelling unit having a common kitchen) possesses any LPG connection from PSU Oil Companies or Piped Natural Gas Connection for domestic use in our dwelling unit. ('Households' having Piped Natural Gas connection are not entitled to subsidised LPG.)
- That I am enclosing a copy of Ration card number ___________________, including my name.
OR
- That I do not have Ration Card in my name or in the name of any member of my 'household', as defined above. As and when a ration card is issued in my name or in the name of any of the members of the 'household', the same shall be produced to the Oil Company LPG distributor for updating records.
(Delete whichever is not applicable.) - That I am enclosing the KYC form duly filled in along with the Proof of Address (POA) and Proof of Identity (POI).
- I confirm that the LPG connection issued to me will be used at my above-mentioned address and for domestic cooking purposes only, and I shall abide by all terms governing its use.
- That I shall not position any other LP gas installations in the same kitchen.
- That as and when the second cylinder is issued to me against this connection, the same will also be used in the same kitchen and with the original installation.
- That whenever I change my residence from the present address to another, I will inform M/s ____________________________ (Name of Distributor / RGGLV) in writing in advance of the change of address in the records.
- That I am aware that the domestic subsidised LPG connection as shall be released by M/s. Indian Oil Corporation (IOCL) / Bharat Petroleum Corporation (BPCL) / Hindustan Petroleum Corporation (HPCL) on the basis of this declaration and information submitted by me in the Know Your Customer (KYC) form, Proof of Address and Proof of Identity shall later be subjected to a de-duplication check for the existence of any other domestic subsidised LPG connection with any govt. Oil Company in my name or in the name of any other member of my 'household' as at para '3' above.
- That if any information/declaration given by me in this undertaking, the "KYC" form or any document submitted in support of identity/residence proof shall be found untrue or incorrect or false, the Oil Company would be within its rights to withdraw the supply of Gas / Terminate the connection/seize the equipment/forfeit the security deposit, and that I would have no claim whatsoever against IOCL / BPCL / HPCL for such withdrawal / Termination / Seizure / Forfeiture.
I hereby declare that whatever has been stated above is true to the best of my knowledge and correct, and nothing material has been concealed therefrom.
Date: ____________
Place: ____________
Signature of person giving the Declaration: _____________________
Name: ___________________________________________
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