New Service Connection
Application for New Customer Connection
Personal Data
Full Name
Phone No
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Valid Email Address
*
Date of Birth
-
Month
-
Day
Year
Date
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Section 2 — Premises details
Connection site
Detailed Address(where supply is required)
LANDMARK
State/Region
*
Adamawa
Borno
Taraba
Yobe
Business Unit- Adamawa
Gombi
Jada
Jambutu- Airport, Faro etc
Jimeta- Police Round About, Mubi Round About etc
Michika
Mubi
Numan
Yelwa - Yola South, AUN etc
Test-Area
Business Unit - Borno
Biu
Bulumkutu
Kanem
Yerwa
Business Unit - Taraba
Jalingo 1
Jalingo 2
Wukari
Business Unit - Yobe
Damaturu
Nguru
Potiskum
Selected BU
Type of Premises
*
2 Bedroom Flat
3 Bedroom Flat
Shop/Boys Qtrs
Duplex
Single Room
Block of Flat
Use of Premises
*
Residential
School
Commercial
Church
Mosque
Other
Select Meter Provider
*
Technovati - Single Phase (N
Technovati - Three Phase (N
Triple 7 - Single Phase (N
Triple 7 - Three Phase (N
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Section 3 — Document declaration
Upload instructions
Valid Means of Identification
*
Driver's License
International Passport
Permanent Voter's Card
NIN
Nationality
Nigerian
Non-Nigerian
Nationality for Non-Nigerian
Identification No (International passport, Driver’s License, PVC)
*
File Upload- Valid ID. (PDF/JPEG)
Browse Files
Drag and drop files here
Choose a file
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File Upload- Completed Electrical Inspection Certificate
Browse Files
Drag and drop files here
Choose a file
Cancel
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Section 4 — Declaration & consent
Final step
Data consent
*
I consent to my information being used to process this application
Declaration
*
I/We (Applicant) confirm that the information given in above is true in it’s entirety and agree that if any part is found to be untrue the electricity supply may be disconnected.
Submit
Should be Empty: