Service Disconnection Form

Complete this online application to disconnect and existing service connection at Go Bleu - Matilda.

Go Bleu - Matilda
5 Maude Street
Cheltenham 3192

Your Details

Tenant or Business Name

Phone (primary contact number)

Email Address

Supply Details

Services Choose your serviceElectricityHot Water

Unit Number Choose your unit101102103104105106107108109110201202203204205206207208209210301302303304305306Brandable BillingG01G02G03G04G05G06G07G08G09PLP

Supply Disconnection Date

Year Month Day

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Notes

Please add any extra notes or comments here

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