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APPLICANT DETAILS

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Mobile Email Postal Code I.D. Card No Flat No Building No Way No Others

Type

Customer Type

Customer Name

Valid I.D. Card No

C.R. Code

C.P. No

ID Card Expiry Date

Tenancy Contract No

Start Date

End Date

Mobile

Telephone

Email Address

Nationality

Electricity Account No

Governor

Wilaya

Village / City

Way No

Building No

Flat No

Po Box

PC

Premises Type

Domestic Industrial Commercial Agricultural Government Tourism/Hotel

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Vat registration certificate

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Valid I.D Card (front Side )

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Valid I.D Card (Back Side )

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Commercial Registration (CR)

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Mulkiyah

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Krooki

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Tenancy Agreement

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Other Documents

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I read and agree to the Supply Agreement
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I read and agree to the Connection Agreement.
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