ORION NETWORK CONNECTIONS

BOUNDARY BOX / TEMPORARY BOX POWER SUPPLY APPLICATION

Form Submitted: 23:54 13-12-2017

Note: Fields marked with a red asterisk (*) are mandatory.

Connection Details:

Connection Type: *

ES No:* e.g. 987654

ES

Has the cable been laid? *

 

If not who is completing this work?

Single or Three Phase Metered Temporary Supply? Use TP1 (Inspection, Metering & Livening Request) Form instead
Address Supply Required At:

Please provide as much information as possible to ensure there are no delays with your application.

DP No:

Lot No: *

Street No & Address: *

Suburb:

Other Comments:
Person Requesting Supply:
Phone Number:
Email Address : * Email address is used to send you a copy of this form submission & other required correspondence regarding this application. Please check your junk/spam folder regularly for status updates regarding this application.
Electrician's Name (if different from above):
Electrician's Business Name
Phone Number:

Power Account Holder Details:

Person/Company Responsible for Account: *
Billing Address: *
Phone Numbers:
Order Number:
Nominated Electricity Retailer: *
Retailer Customer Number: *
Inspection fee charges are to go to: *
 
Security Code:
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