Water & Electricity Termination of Account Application

Please fill out the form below and a customer representative will be in touch with you within 48 - 72 hours.

Occupant Details

Address of Property:*

Leaving Date:

Town:

Full name:*

Date of Birth:

Email Address:*

Phone (Home / Mobile):

Phone (Work):

Forwarding Address:

Suburb:

State:

Real estate company or landlord if applicable:

Failure to provide and accurate forwarding address for outstanding account debts may result in you being listed with a credit agency.

Employer Name:*

Address:*

Town:*

Phone:

Fax:

Mobile:

Employee Code of Applicant:*

Date:*

* Required Field