Fiji Electricity Authority

Private Mail Bag Suva

Fiji Islands.
Contact Centre: 132 333 (24 hrs)
Customer.Services@fea.com.fj
www.fea.com.fj
Monthly Electricity Subsidy Registration Form

Account Number Meter Number____________________

1. Customers Full Name

2. Residential Address __________________________________________________________________________

3. Contact Number __________________________________

4. Tin Number __________________________________

5. Date of Birth __________________________________

6. Email address _______________________________

7. Photo ID (CUSTOMERS TO PROVIDE ANY OF THE FOLLOWING PHOTO IDS TO BE ATTACHED WITH THIS FORM)
FNPF/FIRCA PASSPORT VOTER REGISTRATION DRIVERS LICENCE OTHERS

8. Occupation

9. Combined Household income(Must be filled)

10. This form must be submitted with the following documents.

□ Statutory Declaration Form – Duly signed and stamped by JP/Legal Officer/District Officer or Provincial Officer)
□ Valid Photo ID
□ TIN Letter or Joint FNPF/FIRCA Card Customers Signature :
□ Latest Payslip (IF Employed) Stamped by employer
FOR OFFICIAL USE ONLY

□ West□ North□ Central Eastern

DIVISION

VERIFIED AND UPDATED BY Date:

The following form/documentations has been provided by the customer
□ Statutory Declaration Form □ FEA CIF Form
□ Valid Photo ID □ TIN Letter or Joint FNPF/FIRCA Card
STAMP
□ Latest Payslip

ENDORSED BY Date:
 G.P. FORM 47

STATUTORY DECLARATION

I
of

All information given on the Monthly Electricity Subsidy Registration

Form is Correct & True
And I make this solemn declaration believing the same to be true and by virtue of the
Statutory Declarations ordinance, 1970.
Declared at }
this day of}
, 200 }
before me and I certify that the declaration was read}
over in the }
language to the declarant who appeared fully to }
understand the meaning thereof. }
}
}
}
(Office held or nature of Appointment)