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ActewAGL only services the postcodes in the list, if you live outside this area please contact your retailer.
Note: By authorising below the party nominated above is accepting charges for the works indicated at the top of this form.
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.