Residential Application Move Out
Residential Application Move Out
Residential Application Move Out
PLEASE NOTE: 48 hour advance notice is required for a meter reading. *MANDATORY INFORMATION Insufficient details will not be accepted
P/Code
*Surname Surname
P/Code P/Code
*Phone:
Work Mobile Phone:
Work Mobile
Contact Contact
eg: home, relative’s number, friend’s number eg: home, relative’s number, friend’s number
OR
COMPANY (must be Pty Ltd or Ltd with A.C.N. or A.B.N. number)
*Contact Details
PLEASE SIGN
Applicant’s Address
PLEASE SEE OVER FOR SOUTH EAST WATER LTD PRIVACY STATEMENT
Manark 01/10
P RIVA CY S TAT E M E N T
South East Water is collecting the information requested on this form for the purpose of providing goods
and services to you and improving those goods and services. Without all or part of this information
the goods and services may not be provided to you. This information will be handled in accordance
with our legal obligations. You may request access to your personal information. The information may
be disclosed to third parties in relation to the provision of goods and services, including South East
Water’s contractors assisting in the provision of these goods and services, Melbourne Water, the
Minister or the Environment Protection Authority. For a copy of South East Water’s privacy charter
which describes in more detail how personal information may be used, or details on how to access
your personal information, see the web site at www.southeastwater.com.au or contact 131 694.