新界沙田安麗街六號沙田中心十三樓 13/F, Shatin Centre, 6 On Lai Street, Shatin, N.T. Tel.

: ( 852 ) 2678 2678 Fax : ( 852 ) 2678 6368 Website : http://www.clponline.com.hk

CONFIDENTIAL

APPLICATION FOR TERMINATION OF ACCOUNT
NOTES: This request is to be made, at least TWO full working days in advance, by the registered customer or bona fide holder of ALL relevant deposit receipt(s). 2. The bona fide holder of ALL relevant deposit receipt(s) must produce such receipt(s). 3. This form should be mailed to CLP Power Hong Kong Limited, Record Office, 13/F, Shatin Centre, 6 On Lai Street, Shatin, N.T. or submitted to any of our Customer Services Centres, or transmitted by FAX 2678 6368. 4. Termination of account should not be treated as a request for the removal of this Company’s equipment. 5. To ensure that the premises electrical installations are safe after account termination, please turn off your main switch under safe circumstances. Please ‘ ‘ where appropriate
NAME OF REGISTERED CUSTOMER

1.

ACCOUNT NO.

SUPPLY ADDRESS POSTAL ADDRESS

-

Terminate account on
DATE

/
MONTH

/
YEAR

DEPOSIT REFUND
Electronic Fund Transfer (EFT) I attach a duly completed form and copy of passbook (only the page with bank account no. printed) or statement of the bank account to be credited. [ NOTE : The bank account must be under the name of the Registered Customer if the original deposit receipt is lost.]
Bank Account No.

OR
Bank Account Name

Cheque in favour of Registered Customer
Name of bona fide holder of ALL relevant deposit receipt(s)

Please Note : If the registered customer deceased, please attach a complete Letter of Indemnity (Form D) and copy of Death Certificate / Letter of Administration with this application form.

ORIGINAL DEPOSIT RECEIPT(S) RETURN
(ONLY SUITABLE FOR OPEN ACCOUNT ON OR BEFORE YEAR 2004)

Receipt No.

Amount ( $ )

Original deposit receipt(s) is/are duly endorsed and enclosed for refund by cheque to the above postal address Original deposit receipt(s) will be duly endorsed and submitted to your Customer Services Centre for refund [NOTE : Cheque will be sent after Final Bill is issued ) Loss of deposit receipt(s) I / We, the registered customer(s), have duly completed a Letter of Indemnity (Form L) as attached to this form.

TOTAL ( $ )

(NOTE: Letter of Indemnity can be obtained from Customer Services Centre or downloaded from http://www.clponline.com.hk)
APPLICANT’S NAME IN BLOCK LETTERS (If different from registered customer) REGISTERED CUSTOMER’S / APPLICANT’S SIGNATURE OR STAMP (Company’s Stamp To Be Accompanied By Signature)

PIN / BRC NO. or HKID ( for non-registered
Customers only )

CONTACT TEL. NO. DATE OF APPLICATION:

FOR OFFICE USE ONLY
REQUEST RECEIVED BY FMR / REM / CN C. S. NO. EFFECTIVE DATE

RECORD OFFICE PA
ACTION

ON RECORD

INPUT MADE

INITIAL & DATE

INITIAL & DATE

CREDIT CONTROL 中華電力有限公司
S1800A (10/09)

CLP Power Hong Kong Limited