This form should be completed and submitted at least three working days prior to settlement. Please note that transfers will occur on the 1st of the month following new account approval.

All fields marked with an * are mandatory.

I am completeing this form because:

I am moving out (sold property)

I am moving in (purchased property)

I am the:

Property seller

Property purchaser

Property seller's or purchaser's legal representative

Property and account details

Property Address

Name

First Name

Last Name

Phone Number

Mobile/Home

Contact Details of the seller's legal representative - Optional

Company Name

Representative's Name

First Name

Last Name

Phone Number

Mobile/Office

PLEASE NOTE A NEW ACCOUNT CANNOT BE CREATED UNTIL THE NEW OWNER'S HAS COMPLETED THE ACCOUNT SETUP AND AS SUCH THE PRESENT ACCOUNT HOLDER WILL BE LIABLE FOR WATER CHARGES UNTIL THEN

pine harbour water, 24 Tui Brae, pine harbour marina, Auckland :

phone 021 399006(simon), Admin@pineharbourwater.co.nz (DANA)

OPERATIONS 021 753548 (marcus)