My Details

LETTER OF AUTHORITY

Contact Name:
Office Phone:
Mobile:
Business Name :
ABN & ACN:

Business Address

Unit No:
Street No:
Street Name:
Suburb:
State:
Postcode:

As a part of our process of quoting energy pricing for your account, we require wriiten authority to act on your behalf with some retailers and other relevant parties. Please fill in the required information, sign below and return giving Specialist Energy Management Pty Ltd (SEM) ACN 146 634 997 permission to act on your behalf within the following areas of electricity and gas:-

  • Account Set Up
  • Change of Ownership
  • Novation - Energy Pricing (Electricity & Gas)
  • Tariff Restructuring (when required)
  • Receipt of Energy Bills via our email on request
  • Escaltion of unresolved issues via the Retailer
  • Escalation of unresolved issues via the Ombudsman
  • Authorisation for Retailers to perform Credit Checks
  • Any other matter relating to the effective management of your energy account
  • De-energise a site on request.

Note: This L.O.A gives SEM the ability to source offers/contracts on your behalf but NOT to accept them.
This LOA remains valid from the date of signing unless revoked by you.

Signature
Date

Only complete this section below if your business is not a Proprietary Limited company (Pty Ltd).

If your business is a trust, partnership or sole trader, ie not a Proprietary Limited company (Pty Ltd), energy retailers require the additional information below:

Information provided below must include at least one trustee for each trust involved.

Trustee/ Partner/ Sole Trader's Name Contact Phone No. ABN / ACN
Trustee/ Partner/ Sole Trader's - Residential Address Years at this address Drivers Licence or Passport No. Expiry Date Date of Birth