Your details
Opus Energy account number
Your business name
Title
*
Mr
Mrs.
Miss
Ms.
First name
*
Surname
*
Contact number
*
Email address
Move out 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
Forwarding address building name / number
Forwarding address postcode
Property details
Building name/number
*
First line of address
*
Town
Postcode
*
Electricity meter read(s) on the day you moved out - if applicable
Gas meter read(s) on the day you moved out - if applicable
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.
