TENANT DETAILS (To be completed by Tenant) Please mail the original completed form to: PACIFICLIGHT ENERGY PTE LTD, Customer Service, 460 Alexandra Road, PSA Building #10-01, Singapore 119963. Company Name: ____ Business Registration No.: Daily Operating Hours: Premise Address: ____ Mailing Address (if different from the Premise): ____ ____ Person-In-Charge (PIC) Name: PIC Designation: DOCUMENT REQUIRED: PIC Contact No. (Office): PIC Contact No. (Mobile): PIC Fax No. (Office): PIC Email: GIRO Billing Preference: METER DETAILS Cheque Completed and signed Account Opening Form Completed and signed GIRO form Copy of ACRA business profile Copy of NRIC or passport of applicant Proof of Tenancy (eg. Copy of Tenancy Agreement or Letter of Undertaking & Indemnity) (Tenant meter details to be completed by Building Management Officer / LEW and has to be agreed by Tenant) Meter Location: Meter Serial No.: DOCUMENT REQUIRED: Multiplier Factor: Photo of Meter for Tenant’s unit Opening Meter Reading: Commencement Date (DD/MM/YY): Signature and Company Stamp Building Management Office’s Endorsement Name (Print in Full): Designation: ___________________________________ Date (DD/MM/YY): ________________________________ ______ I/We, the Tenant, agree to the above completed information by both Tenant and Building Management. I/We, the Tenant, agree to join the Landlord, as the case may be, of the building known as _________________________________________________________ (“Building Name”) in its procurement of electricity through PacificLight Energy Pte Ltd (“PacificLight”). In consideration of PacificLight supplying electricity to the premises address named herein, I/We, the tenant hereby agree(s) to be bound by the Terms and Conditions set out herein which I/We have read and fully understand. I/We, the Tenant, shall pay an initial deposit and maintain it at an amount not less than 2.0 times of the monthly electricity charges. We understand that Security Deposit is subject to PacificLight’s quarterly review and revision from time to time based on actual consumption. I/We, the Tenant, shall pay a late payment charge (LPC) of 1% of the invoice value per month should there be Late Payment incurred. PDPA Consent I/We hereby consent to the disclosure of my/our personal data by PacificLight to the Landlord/Building LEW, Singapore Power or such other third parties as may be necessary for the purpose of opening this electricity account with PacificLight. PacificLight may retain my/our personal data for such period as is necessary until there is no legal or business purposes for retention. Tenant’s Endorsement: Name (Print in Full): Signature, Company Stamp Designation: Date (DD/MM/YY): FOR OFFICIAL USE ONLY Date Received of Application Form: Security Deposit Amount and Received on: Security Deposit in the form of: GIRO/Cheque PacificLight Account No.: Processed by and date: ___________________________ PacificLight Energy Pte Ltd (Co. Reg. No. 200211051N) 460 Alexandra Road PSA Building #10-01 Singapore 119963 Tel: 66035959 Fax:65333502 Email: [email protected] Page 1 of 1 Rev.2.0/05/1 5
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