Application for removal of gas supply

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Work to be performed

 

Work site details

 
 
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ActewAGL only services the postcodes in the list, if you live outside this area please contact your retailer.
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Please note:  The distributors will not call you to make access arrangements; please ensure that there is safe access to the meter. Completion of the meter and service disconnection can take up to 5-10 working days. It is your responsibility to ensure safe access is available from the time the request is made until the completion of the meter removal and disconnection at the street has taken place.

Account holder details

 
 
 
 
 
 
 
 
 

Note: By giving authority the Account Holder authorises the performance of the work indicated above. Authority is given to bill the party named in the section below for the work.

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Invoice instructions

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*   dd/mmm/yyyy
  (Example 22/Apr/1994)
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Note: By authorising below the party nominated above is accepting charges for the works indicated at the top of this form.

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Disclosure of credit information to a credit reporting agency (Privacy Act 1988) – This Application constitutes a contract for consumer credit. We may give credit information to a credit reporting agency for the purpose of obtaining a consumer credit report about you and/or allowing the credit reporting agency to create or maintain a credit information file containing information about you. This information may be given before, during or after the provision of credit to you. This information is limited to: your name and address; the fact that you have applied for credit under this Application; the fact that we provide credit to you; the existence of any loan repayments which are overdue by more than 60 days and for which debt collection action has started; information that, in our opinion, you have committed a serious credit infringement; or information about cheques drawn by you for $100 or more which have been dishonoured more than once.

Your privacy is important to us and we are committed to handling your personal information in accordance with the Privacy Act 1988 (Cth). Our Privacy Policy sets out how we collect, hold, use and disclose your personal information. Read ActewAGL's privacy policy in full here.

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