Varsity Towers Move Out Form

Important Move Out Reminder
Please be aware that your power will be DISCONNECTED within 3 hours of completing this form.
The form will only be completed and submitted when you see the following screen.
Make sure you click on the next button on each page until you see

located under the "feedback" page.
Account Type
Customer Type*
Valued Customer Details
Meter Number*
This is an 11 digit number located on your meter and or switchboard
Full Legal Name*

PrefixFirst NameMiddle NameLast Name
Trading Name*
ABN/ACN*
Disconnection Address*

Unit Number

Street Address

CityState / Province

Postal CodeCountry
Mobile Number*
E-mail*
Take Photo Of Remaining Credit Balance*

Identification Details
Personal Identification Type*
Authentication Number*
Date Of Birth Day/Month/Year*
Upload a File
Please Take Photo Of Your ID (If screen is black press the turn camera around button top right corner) Cancelof
Account Disconnection Payment

Disconnection Move Out Reading Fee$12.54AUD

Subtotal $0.00AUDTax $0.00AUDTotal $0.00AUD

Payment Method
Credit	Express

Important Move Out Reminder