Account Application Form

Please use the Application Form below to open a utility account. Please note that Zici Energy only supplies specific locations.
Upon completing the application form, the next step is to make a payment of $150. This amount will be held as a security deposit and will be fully refunded upon termination of our service, provided that all bills are paid and up to date. Deposit paid into : 12-3075-0009791-04 https://zicienergy.com/pay-bills/

Terms and Conditions

Full terms and conditions of supply are available HERE.

LOCATION

Please enter the supply address that you are applying for. Please include the apartment number and building name if applicable.

Move in date (or power connection date if earlier)

YOUR DETAILS

Please enter your name, contact details, invoice preferences and identification details.

Date of Birth:

Identification Type

Identification document expiry date:

Scan or photograph of identification and any other relevant files

Medical Dependence

A medically dependent person is a person who is dependent on mains electricity for critical medical support, such that the loss of electricity may result in loss of life or serious harm.

YesNo

Owner/Tenant

I am the tenant at the supply address
I am the owner at the supply address

AGREEMENT

By signing and submitting below I agree to pay for utilities supplied to me at the above supply address. I also understand and agree that failure to pay in fully and on time may result in my utility account details being shared with my landlord, the Body Corporate or building owner and third party collection agencies for the purpose of debt recovery.

E-Signature

Signature Dated

I have read and agree to Zici Energy terms and conditions, available to view by clicking the 'Review Terms and Conditions' button at the bottom of the page.