Service Disconnection Form

Complete this online application to disconnect and existing service connection at Union Apartments.

Union Apartments
178 Union Road
Surrey Hills 3127

Your Details

Tenant or Business Name

Phone (primary contact number)

Email Address

Supply Details

Services Choose your serviceElectricity

Unit Number Choose your unit12101102103104105106107108109110201202203204CommonG01G02G03G04G05G06G07G08G09G10G11Gateway

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