Prepaid Meters Sign Up Electricity Form

To complete this connection form you will require the following:
5 Minutes of Your TimeIdentification (Drivers License/Passport or Equivalent)Mobile Phone NumberEmail AddressLeasing Agent (If Renting)

Important Reminder
The form will only be completed and submitted when you see the following screen.
Make sure you click on the next button on each page until you see

located under the "feedback" page.
Account Type
Customer Type*
Are you or anyone who will be residing with you at the premises on life support equipment ?*

As the nature of prepayment may not be suitable for your requirements, please first fill out the Life Support Form at:

Click Here

or call

1300 880 375

Sorry for any inconvenience caused.

Valued Customer Details
Meter Number
This a 11 digit Number located on your meter and or on your switchboard
Full Legal Name

PrefixFirst NameMiddle NameLast Name
Trading Name*
ABN/ACN*
Connection Billing Address*

Unit Number

Street Address

CityState / Province

Postal CodeCountry
Mobile Number*
E-mail*

Identification Document
Personal Identification Type*
Authentication Number*
Date Of Birth Day/Month/Year*
Upload a File
Please Take Photo Of Your ID (If screen is black press the turn camera around button top right corner) Cancelof

Concession Eligibility
Are you a holder of any of the following cards as you may be eligible for a concession?

Pensioner Concession Card Issued by the DHS/DVADHS Health Care CardDVA Gold Card
Authentication Number*
Concession Card Upload*

Upload a File
Please Take Photo Of Your ID (If screen is black press the turn camera around button top right corner) Cancelof

Feedback
How was your sign up experience?
Comments
We value your feedback. Please tell us how we can improve the customer experience.

If the form is complete and accepted you will be redirected to a page where you can purchase your first electricity token.

Please allow up to 5 minutes to be able to purchase electricity for your account.
Should be Empty: