Power of Attorney

Complete all required fields and submit the form.

Email Address *

If you submit this form again while it is still pending, we will show the existing submission instead of creating a duplicate. Allow for your application to be reviewed if you want to submit another one.

Principal

Name & Surname *

ID Number *

Address *

(the address acts as the dimicilium citandi et executandi)

Email *

Date *

Cell *

Signature *

Type your full name as your signature.

Agent

Name & Surname *

ID Number *

Address *

(the address acts as the dimicilium citandi et executandi)

Email *

Cell *

Signature *

Type your full name as your signature.

Appointment

The Principal appoints the Agents as his/her/their representative for the purposes of applying for Utilities (Electricity/Water) to the premises below of which I am the owner/responsible person.

Estate Name *

Unit No *

Physical Address *

Town *

I have read and accept the terms and conditions.