SmartConsult Customer Form

SmartConsult

Customer Information Form
Internal sales team

(*For internal use only)
Password
Project Manager*
Sales Person*
Pick Name
Sales Person E-mail*
Type in your email address
Installer*
Installer Name
Co Division*
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

CityState

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

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

DayMonthYear
Contact Name*

First NameLast NamePosition
Signature

Clear