Customer & Premise Details

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* 1. Energy Retailer

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* 2. ICP

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* 3. Surname

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* 4. First Name

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* 5. Street Number and Name (e.g 17 Smith St)

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* 6. Suburb (e.g Tawa)

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* 7. Please indicate the eligibility category used to qualify for the Electric Vehicle and Battery (EVB) pricing plan?

T