Residential Water & Electricity Account Application Form

Please tick whether this is for one or both utilities


This form must be returned at least 48 hours prior to connect required.

      
Is there a dog on the property?
If Yes, please refer to section 7 of the terms and conditions
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Type of Dwelling:
Type of Occupancy:

Personal Details

      
Sex
Please select
Do you have a life support system at the premises?

You must complete this section if your employer is paying for the account.

Employer to pay all costs?
Do Pilbara Iron subsidies apply?

This application will incur an Account Establishment Fee of $23.50 (GST inclusive) If Pilbara Iron requires further information about my/our application, I/we agree to allow Pilbara Iron to obtain a report containing information about my/our personal credit from a credit reporting agency or other agency. Pilbara Iron has informed me/us that it may give certain personal information about me/us to a credit reporting agency. I/we confirm that I/we have read and understood the Pilbara Iron's terms and conditions of supply printed below. I/We agree to abide by these terms. I/We understand that the energy supply may be disconnected without notice if these terms are not met. I have read and understand the terms and conditions attached.

      

Concessions

Customers are entitled to concessions on Pilbara Iron accounts if they hold one of the following cards: Pensioner Concession Card, Health Care Card, Senior Citizens Card, Veterans Affairs Repatriation Health Card. A copy of this card MUST be forwarded to us with the application.

Terms and Conditions of Supply

1. This application shall not be binding on Pilbara Iron Pty Limited until receipt of your Account Establishment Fee. Your completed application form must be returned to Pilbara Iron Utilities within seven days, or your supply may be disconnected.

2. The Supply Authority shall not be responsible or liable for any injury, loss or damage which may occur to the customer's premises, fittings, fixtures, furniture and personal belongings including those of his licensees or invitees no matter how so ever such injury, loss or damage may occur. (This includes but is not limited to injury, loss or damage caused by increases or decreases in the voltage or other change in the energy supplied or failure of any apparatus instrument, meter or appliance owned or supplied by the Supply Authority). The customer shall indemnify and keep indemnified the Supply Authority against all claims, demands, suits, actions, costs and damages arising from loss or damage to any property and caused directly or indirectly by the supply of energy to the consumer's premises.

3. Pilbara Iron account terms are strictly 28 days.Failure to pay within these terms may result in disconnection of supply without notice. If charges are to be paid by your employer then the employer must complete this application form in co/tenant section. Please note it is your responsibility to ensure your employer pays this account.

4. Details of Normal Supply - 415/240 Volts, 3 Phase, 50Hz.

5. After Hours Reconnection (from 3.30pm to 7am) will incur an after hours re-connection fee ($192.75 GST inclusive).

6. Special Read Fee $19.20 may apply if we are unable to access your meter to read on nominated dates.

7. DOG OWNERS - For the safety of our meter readers, customers must advise Pilbara Iron of dogs on premises. Customers are to ensure dogs are restrained when meter readers are completing readings. Failure to comply may result in your property being assessed and also the special read fee might apply if we need to complete a special meter reading.

8. Disconnections will incur a Special meter Reading Fee of $23.50 (GST inclusive). A Termination Form must be completed and returned to Pilbara Iron Customer Services upon vacating the property. Failure to comply will result in you, the vacating tenant, being charged up until a termination form has been received.

9. WICKHAM CUSTOMERS: please note: connection is not availableuntil an electrical inspection has been completed and advice received from Robe River Pilbara Iron authorising connection.

10. IMPORTANT NOTICE TO APPLICANT(S) FOR CREDIT (SECTION 18(E)(1) PRIVACY ACT 1988). Pilbara Iron reserves the right to vary its fees and charges without notice.

 

Notice of disclosure of your credit information to a credit reporting agency (Privacy Act 1988):

1. Pilbara Iron may give information about you to a credit reporting agency, for the following purposes: 1. To obtain a consumer credit report about you, and/or to allow the credit reporting agency to create or maintain a credit information file containing information about you.

The information is limited to:

2.  Identity particulars - your name, sex, address (and the previous two addresses), date of birth, name of employer, and driver's licence number.

3. Your application for credit or commercial credit - the fact that you have applied for credit and the amount.

4. The fact that Pilbara Iron is a current credit provider to you.

5. Loan/Account repayments/payments which are overdue by more than 60 days and for which debt collection action has started.

6. Advice that your loan/account payments/repayments are no longer overdue in respect of any default that has been listed.

7. Information in that the opinion of Pilbara Iron you have committed a serious credit infringement (that is, fraudulently or shown an intention not to comply with your credit obligations).

8. Dishonoured cheques - cheques drawn by you for $100 or more - that have been dishonoured more than once.

9. That credit provided to you by Hamersley Iron has been paid or otherwise discharged.

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