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AGA APPLICATION Wastonat TO CLOSE ELECTRICITY ACCOUNT Please read this uideine before fing up this oppiation form. ‘© To.avold any delay in processing your request, pease ensure thot ol fds inthis form are completed anda capy of your MyKod/Possport is ‘ottached. You wllneed to be present during the supply connection I the meter is located aside your premises + Please complete the form and send by hard or registered mai to TNB office (nearest the premise which occounti tobe closed), together With @ copy of your MyKod/Posszart.Pleose be Informed that a minimum of three (3) working days is requied for your appcaion to be processed. 1. would ike to apply for termination of electricity supply forthe premises below: Name Account No. Promises Address This Premise is currently O ‘occupied by myself or vacant [_ Joccupies by others 2. Preferred date of supply’s disconnection and meter's removal (ay) ___(month) _{year) The earliest appointment date (subject to availability) is within thrce (a) working days after we receive this application form. 3. acknowledge that the security deposit will be used to offset my final charges (ifany] before any credit halance could be ‘refunded through the method indicated below [please tick one checkbox onl [Ll transfer to my other active TW Electricity Account? TNB Account Number credit via bank ACCOUNT Account Number: credit va ant = THIRD PARTY ACCOUNT? Account Number: Account Holder Name: IC Number/Mykad: Cl creque oe: also applicable when debit bolonce occurs, TNA may transfer the debit balonce ofthe electricity account to any active electricity account whichis egistered under the some registered customer. “Aplicantis expected to get the consent ofthe third party stated and must give their accurate information. TNA shallot be held ‘accountoble should any sue aries from the use ofthe third porty account 4, Please provide your latest correspondence address fr final bill or refund cheque purposes: latest Correspondence Address Contact No. (Home/Mobile) 5. DECLARATION: a) hereby declare that all the details furnished above are true and if any of the above information is found to be false or misleading, TNB shall reserve the right to take any other action as may be deemed appropriate )_ hereby give my consent to TNG and/or agree to assist TNB to enter int the said premises forthe purpose of disconnection of clectricity supply. n the event that the electricity supply could not be disconnected or meter could not be removed from the premises despite all reasonable efforts by TNS to do so or due to unavoidable circumstances, | hereby shall be responsible to pay for all charges with regards to the electricity consumption at the premises until the actual execution of supply's disconnection and meter's removal Signature or thumb print / Date: For account under compary, the signoture of ts legol Authoried representative ofthe compony and the Compony’s rubber stamp imprint ‘srequred. Name Email (ifany) eee Ic Number/Wiykad ‘Company's Rubber Stamp (of accaunt holder a the person signing forthe company) @ PERMOHONAN NASIONAL PENUTUPAN AKAUN ELEKTRIK. Sila baco panduon ini sebelum mengisi boron. ogi mengelotkon sebarong kelewotan memorosespermahonan tuen/uon, sia pstin bahowa semua ruong telah dipenuhi dan sat salinan Myxod/Posportdsertokan bersoma. Tuan/suan peru had bersoma alos! sewortbekoion eek dipotongsekirony meter terletoé o.dolam kowasan premistuan/puor. ‘ila majukon borang yong telah allengkapkon secoro serohontangan atou pos berdjar ke pejabot TNS (yang poling hompir dengon premis ‘akoun yong ingin ditwtup, bersame-sama salinon Mykad/osport. Horop maklum bahowe proses permahonantuan/auan akan renga! masa sekurang-urangrya tiga (3) hal bekerja 4, Saya memohon untuk menamatkan bekalan elektrik ke premis seperti bawah’ Nama Nombor Akaun Alamat Premis Premisinisekarang [ ] Diduduki oleh saya atau telah dikosongkan Diduduki oleh orang lain 2. Tarkkh pemotongan bekalan dan penanggalan meter ingindibuat pada (hari) _(bulan} {Tarith poling awal untuk menetapkan temujanji datos (trtatluk kepeda kesedioan sumber) adalah sekurong-kurong

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