1. Type of disconnection(s)
*
Select the type of energy you want to disconnect.
(You can select both)
Electricity
Gas
2.
Disconnection date
Must be a business day. Please allow at least two business days notice.
e.g.
15/03/2010
(dd/mm/yyyy)
3. Your details
*
Customer number
:
Title
:
*
First Name
:
Middle Name
:
*
Surname
:
4.
Customer type
Rural
Domestic
Business
* If
Business
, please enter:
*
Trading name
:
*
ABN
:
5. Proof of identity
*
Date of birth
:
e.g. 16/03/1974
*
Driver's licence number
:
Or
a password you nominate.
6. Address that you want to disconnect
Property name
:
National Metering Identifier
: For electricity connection only
** NMI:
Note:
The NMI number for the premises will be shown on a recent bill for that premises. It uniquely identifies your premises in the national electricity market. If you do not have that information, please complete the Service address box.
And / Or
Service address: For electricity or gas connection
**
Street
:
**
City / Suburb
:
**
Postcode
:
State
:
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
7. Forwarding postal address
*
Street or PO Box
:
*
City / Suburb
:
*
Postcode
:
State
:
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
8.
Do you have a dog or dogs at the service address?
Yes
No
*
If
Yes
, please enter breed(s)
9. Access to meter box
Is there any issue that the meter reader should be aware of?
e.g. Meter box behind a fence or gate.
10. Please enter your contact details
**
Home phone
:
**
Work phone
:
**
Mobile
:
Email
:
*
Preferred method of contact
:
Home phone
Work phone
Mobile
Email
Concerned about Privacy? Please be aware Country Energy will only use this information for the purposes outlined on this page. For more information on Privacy, please refer to our
Privacy Policy
.