Staying Connected form

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Security statement

ActewAGL takes your privacy seriously. We take many steps to protect your privacy and keep your personal information secure. The information you give us will never be provided to third parties or used to send unsolicited emails.

Read ActewAGL's privacy policy

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Customer details

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*
*   dd/mmm/yyyy
  (Example 25/Apr/1990)

Contact details

 
(Example: 0x xxxx xxxx or 04xx xxx xxx)
 

Disaster affected

*

Concession card details (if applicable)

By supplying us with your concession card details we can help ensure all eligible energy rebates are applied to your accounts.

*

Account details

 
 
 

What can you afford to pay regularly towards your account(s)?

   
   
   

Start date for Payments to commence

 
 

(click on calendar to select date)
 
 
 

Add supporting document (not compulsory)

 
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