Moving Out Notice

Account Holder details
Account #*
First Name*
Last Name*
Date of Birth*
DD slash MM slash YYYY
ID Type*
ID Number*
Contact Number*
Vacating details
Moving Out Date*
DD slash MM slash YYYY

Please select a future business day

Please note: Disconnections available Monday-Friday excluding Public Holidays.
Forwarding Information
The addresses below will be used to receive your final bill and any notices.
Email Address*
Postal Address*
If unknown enter preferred address
Please send my final bill and notices via*
- Email address
- Postal address
Acknowledgement*
As the account holder, I hereby declare that the details entered above are to the best of my knowledge true and correct . I understand that vacating the premises is subject to the Terms & Conditions of my contract.
Email
This field is for validation purposes and should be left unchanged.

Account Holder details