Your details
Title
*
Mr
Mrs.
Miss
Ms.
First name
*
Surname
*
Contact number
*
Email address
Move in date
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2023
2024
2025
Your business name
Company registration number (If Ltd)
Home address (If Sole Trader)
Property details
Building name/number
*
First line of address
*
Town
Postcode
*
Electricity meter serial number(s) - if applicable
Electricity meter read(s) on the day you moved in - if applicable
Gas meter serial number(s) - if applicable
Gas meter read(s) on the day you moved in - if applicable
Is this energy supply business use only?
*
Yes
No
Landlord/Managing Agent details
Landlord/Managing agent business name - if applicable
Landlord title
*
Mr
Mrs.
Miss
Ms.
Landlord first name
*
Landlord surname
*
Landlord/managing agent contact number
Landlord/managing agent email address
Customer declaration
*
I can confirm that the information provided in this form is accurate and accept that I can be held accountable for charges for any period should new information be provided at a later date.
