Service Disconnection Form

Complete this online application to disconnect and existing service connection at Dome Currambine.

Dome Currambine
Unit 7, 74 Delamere Ave
Currambine 6028

Your Details

Tenant or Business Name

Phone (primary contact number)

Email Address

Supply Details

Services Choose your serviceElectricity

Unit Number Choose your unitImport Export MeterSolar PPA

Supply Disconnection Date

Year Month Day

JanFebMarAprMayJunJulAugSepOctNovDec1234567891011121314151617181920212223242526272829303120212022202320242025202620272028202920302031

Notes

Please add any extra notes or comments here

Do you accept the Terms and Conditions?

Disconnect My Service Cancel