This form should be completed and submitted at least three working days prior to the required final meter reading date.

All fields marked with an * are mandatory.

I am completeing this form because: *
I am the: *
Property and account details
Account Holders Name *
Account Holders Name
Contact Details of the Seller
Name of Seller *
Name of Seller
Mobile/Home
Contact Details of the seller's legal representative
Representative's Name *
Representative's Name
Mobile/Office
PLEASE NOTE A NEW ACCOUNT CANNOT BE CREATED UNTIL THE NEW OWNER'S INFORMATION IS PROVIDED AND AS SUCH THE PRESENT ACCOUNT HOLDER WILL BE LIABLE FOR WATER AND WASTEWATER CHARGES UNTIL THE NEW ACCOUNT HOLDER'S INFORMATION IS PROVIDED TO PINE HARBOUR WATER.
Contact details of the purchaser
Name
Name
Mobile/Home
contact details of the purchaser's legal representative
Representative's Name *
Representative's Name
Mobile/Office
Let us know your contact details so we can confirm the meter reading and contact you in case we have to reschedule the reading.
Your Name *
Your Name
Mobile/Home
Please allow three working days