ORION NETWORK CONNECTIONS

BOUNDARY BOX / TEMPORARY BOX POWER SUPPLY APPLICATION

Form Submitted: 01:02 21-06-2018

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: *
Contract Terms: *
In accepting this application Telpower 2015 Limited understands that we will supply, install, connect and liven to the network all the necessary material and act as agent for the person requesting supply, his/her customer or, the entity to whom the final account will be provided.

I, the applicant, agree to these terms.
 
 
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