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NORTHERN REGION WATER BOARD

PREPAID WATER METER PENALTIES PAYMENT FORM

Payment method

Cash Cheque Debt Add

Prepaid Customer Details


Account Name: Prepaid Customer Number:

Postpaid account: Customer Class:

Area:

Prepaid Meter Number: Phone Number:

Customer Signature:

Payment made for: Amount


Self opening of meter box MK5,000.00

Damaged/ removed meter box MK18,600.00

Damaged CIU MK46,600.00

Damaged meter MK121,400.00

Meter tampering `

Magnetic interference `

Meter by-pass `

Customer Monetary Details

Amount of existing Debt in system: Total debt added (MK):

New debt in system (MK):

Zone Accountant’s Signature: Date:

Authorization for Issuance of Replacement Item

Name : Designation:

Signature: Date :

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