Ex Tropical Cyclone Narelle customer assistance form

Relationship to account

I am a

Property owner Tenant or lessee Managing agent Other

First name

Last name

Phone number

Email address

Account number (optional)

Property address

Suburb

Postcode

Is this property a home or business address?

Home Business

Are you able to live in your home?

Yes No

Where are you currently residing?

Please provide details of any damage you’ve experienced and/or the assistance you require

Do you currently have a direct debit with us?

Yes No

Email Phone

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