C1 Request for Supply or Meter Verification Form

Please note: there will be an administrative charge if your supply details are found to be correct.

I give consent * :

This must be ticked in order for us to process your application

Customer Reference Number (10 digits) * :

Company Name * :

Premises Name:

Premises Number & Street * :

Town/City * :

Postcode * :

Customer Name * :

Contact Number * :

Email Address * :

Is your supply metered? * :

Yes

No

Meter Serial Number:

What do you believe is incorrect about your current supply arrangements or how you are billed for them? * :

Why do you believe they are incorrect? * :

Please provide any evidence to support your claim:

Additional Documentation:

Security Code * :