Customer Information Form Water Authority Of Fiji

ADVERTISEMENT

WaterAuthority of Fiji
Nasinu, Suva.
GPO Box 1272, Suva
Republic of Fiji
Phone 3346777
.fj
CUSTOMER INFORMATION FORM
Passport Photo
DATA UPDATE
Full Name: _______________________________
Date of Birth: ______________
Father’s Name: __________________________
Marital Status: ________________
Spouse Name: _____________________
Identification Type:
ID No.: __________________________
Drivers License
Passport
Specify:________
Others
TIN No & copy of TIN letter: _________________
FNPF No:
________________
Phone Contact: Landline _______________
Mobile_______________
Occupation: ____________________
Employer:
_____________________
Work Contact: ___________________________
Email:
_________________________________
E-Bill (bills to be sent to this email address)
Physical Address:
Postal Address:
LOT/House No:________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
Meter No: _________ Account Number: ______________________________
Owner
Tenant
(tick appropriate
box)
Would you like your water bill to be sent to your email address and not your postal adress?
Y/N__________
DECLARATION
I, _________________________ of_______________________________ do hereby, solemnly and sincerely
declare that all information provided herein is true and correct and to the best of my knowledge. I hereby
authorise the Authority to use the information for the purpose of updating their records and any other purposes
befitting the efficient discharge of their responsibilities.
_____________________
(Signature)
_________________ (Date)
_____________________ (Meter Owner/Land-Lord)
_________________ (Date)
Customers are reminded that as part of the Authority’s condition of service, it is important that all true and correct
information is provided. Customers who do not adhere to this condition can expect their water supply disconnected.
Therefore, customers are urged to provide all the necessary information in this form and deliver to the nearest
Customer Service office.

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Personal Information Form And Authorization Of Indirect Collection, Use And Disclosure Of Personal Information Personal Information Form And Authorization Of Indirect Collection, Use And Disclosure Of Personal Information Business
Customer Information Form - Cornerstone Information Systems Customer Information Form - Cornerstone Information Systems Business
Customer Information Form - Larson Juhl Customer Information Form - Larson Juhl Business
Customer Information Form Customer Information Form Business
Customer Information Form Us Orthotics Customer Information Form Us Orthotics Business
Customer Information Form - Womens International Pharmacy Customer Information Form - Womens International Pharmacy Business
Customer Information Form - Brilliance Customer Information Form - Brilliance Business
Customer Information Form - Bang Printing Customer Information Form - Bang Printing Business
Customer Information Form Kurt J Lesker Company Customer Information Form Kurt J Lesker Company Business
Customer Information Form Customer Information Form Business

Related Categories

Parent category: Business
Download
Go