SmartConsult Customer Form

SmartConsult

Customer Information Form
Internal sales team

(*For internal use only)
Password
Sales Person *
Pick Name
Installer *
Installer Name
Sales Person E-mail *
This form provides consent for SmartConsult to request interval data and customer electricity useage information.

Account information that may be made available to SmartConsult includes;

✓ Start and End Contract Dates
✓ Latest Bill for Auditing Purposes
✓ 15 min or 30 min (Electricity Consumption) Interval Data File
✓ Annual Gas Consumption Data (If Applicable)
Company Name *
Address *

Street Address Line 1

Street Address Line 2

City State
PostCode *
Customer E-mail *
Mobile Number
Phone No
Company Details

Enter Business Details
ABN No *
Type of Business *
Power Retailer
Property Owner Y/N *
Power Company Name *
NMI No 1 *
NMI No 2
NMI No 3
NMI No 4
Load into Quote Database *
Y/N
Power Contract Expiry Date

Day Month Year
Contact Name *

First Name Last Name Position
Signature

Clear

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