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Disconnection Application

Name: Ocean Reef Renewable Energy
Price range: $

Applicant Details

Name

First Name

Last Name

Email Address

Phone Number

Ocean Reef Renewable Energy Account Number

Are you a Life Support Customer?

Yes

Supply Address

Meter Number

NMI Number (if known)

Lot Number

Street Number

Street Name

Suburb

Post Code

Supply Type

Standard i.e. 3 Phase 32 amps or Single Phase 63 amps

Non-Standard

Unknown

Connection Type

Temporary Supply

Permanent Supply

How many meters do you need disconnected?

When do you need the meter(s) disconnected?

Is Reconnection required on the same day?

Please tick yes if applicable

Comments

Authorised Electrical Contractor (if applicable)

You can nominate an Electrical Contractor to engage with us in relation to your Disconnection request, including us providing details about the Disconnection.

Business Name

Business Job Title

Registration or Contractor Number

Name

First Name

Last Name

Contact Number

Email Address

Authorisation Start Date

Authorisation End Date (if ongoing, leave blank)

I now appoint and authorise the Electrical Contractor to receive information about my Ocean Reef Renewable Energy Disconnection Request, at the supply address listed above, for the authorisation period outlined.

Yes, I agree

Signature

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Applicant Details

Supply Address

Authorised Electrical Contractor (if applicable)

You can nominate an Electrical Contractor to engage with us in relation to your Disconnection request, including us providing details about the Disconnection.

Note: Disconnection pricing will be provided following receipt and review of an application, as pricing is subject to the nature of the request.