Meter Request Form

Meter Request Form

Title

First Name

Last Name

Address

Street Address:

Suburb:

State:

Postcode:

Phone

Date Of Birth

Is there life support equipment at this location?

Drivers Licence or Passport or Medicare Number

Retailer

Please specify

National Meter Identifier (NMI)

Please select the applicable below from the drop down boxes provided

Service Type

Number of Phases

Off Peak / Controlled Load

Work Request Type

Meter Number(s)

Connection Type

Description of Work

Please upload any supporting documents here.

Choose Files

Business / Company

Contact Name

Contact Number

License Number