Service Works Request for a supply
and meter removal service
(Electricity)
Please complete all applicable sections of the form in block letters and tick any boxes relevant to your application.
If your form is incomplete, your application may be delayed.
Use this form to apply for:
• Removal of existing electricity supply and meter
• NSW, ACT, SA and QLD customers only
Please send your completed form to us via:
Email: elecabolishments@energyaustralia.com.au
Post: EnergyAustralia Electricity New Connections
Locked Bag 14060
Melbourne City MC VIC 8001
Fax: 1800 654 295
If you have any questions, or need help with your application,
please call us on 1800 818 378 (Monday to Friday, 8am-5pm AEST)
and we’ll be happy to help.
1. Site address
Lot no: Unit no: Street no:
Street name:
Suburb:
State:
Postcode:
Electricity meter or NMI no:
2. Applicant Details
3. Site and metering details
Title:
Meter numbers: Date premises will be vacant:
First name: Last name:
Unit no: Street no: Street name:
Mailing Address:
Access details:
Suburb:
State: Postcode:
Mobile:
Alternative phone number: Email:
Business name (if applicable):
ABN:
4. To be completed by the account holder
Please indicate your acceptance by signing below.
I authorise EnergyAustralia to arrange for the Distributor and/or metering service provider to completely remove the electricity supply at the address provided in this
application form. I understand that the removal is subject to weather conditions and clear and safe access to the site, including the switchboard. I agree to accept any
charges associated with the meter removal/abolishment and understand these charges will appear on my electricity bill. I understand that if the technician determines
additional works are needed they will not commence the job and EnergyAustralia will contact me to discuss any additional charges and/or work required.
Information about our privacy policy
EnergyAustralia collects information for the purposes of providing the services related to your electricity supply at the site address. In order to provide the services,
we will disclose this information to the metering service provider and/or electricity distributor in accordance with our privacy policy which can be found at
energyaustralia.com.au/privacy.
EnergyAustralia Pty Ltd ABN 99 086 014 968
Locked Bag 14060
Melbourne VIC 8001
Date:
Signature of applicant
Mailing address
