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CLOSING UTILITY ACCOUNT FORM
ACN: 110 581 809 Fireline Group Pty Ltd Trading as Switchbanks B/N 198 192 49

Switching Utilities

Dear Utility manager/clerk or organisation,

I request that my Energy/ Utility Account / Electricity/ Gas/ Other

_____________________ (circle one) be closed.

Please transfer/switch and close all my account information to my new Utilty of choice as indicated below. If unable please totally close my account.

If this form is not sufficient information to authorise the closure of my Utility account please forward to me the appropriate form/s to ensure proper closure

Thankyou for your assistance in this matter.

* First Name :
* Last Name:
* YOUR OLD UTLILITY ACCOUNT NUMBER HERE:
* ANY OTHER ACCOUNT NUMBERS HERE
* SWITCHBANKS :	INFORMATION NEEDED FROM SWITCHBANKS NO MORE INFORMATION NEEDED
* E-mail Address:
* Phone number:
Fax number:
Work Number :
Mobile number:

SELECT THE OLD UTILITY YOU WERE WITH?
Your Address:
City:
State:
Post Code:
Country:
* YOUR NEW ACCOUNT NUMBER HERE:
*CLOSING ACCOUNT YES/NO
* SWITCHBANKS :	PLEASE CLOSE MY ACCOUNT PLEASE SEND MY LAST ACCOUNT BILL ASAP
* New Address:
* Additional Accounts:
:
:
:

SELECT ERGON ENERGY

Comments/Questions:
Switchbanks thanks you for the opportunity to submit your closure form. “Utility solutions have now taken a real turn,” Authorised Approval Signature:…………………………………….

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