Simply complete this form so we can help save you time and money.

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1. Personal Information

First Name*
Last Name*
Email*
Mobile*
Role*

2. Business Information

Trading Name*
Company Name*
ABN*
ACN (For Trusts)
Postcode*

3. Your current energy supply agreement

Energy type*
Energy type (You can select both)*
Nearest Contract End Date
DD slash MM slash YYYY
Quantity of sites
Does this site support Life Support Equipment (LSE)?*
Does this site support Life Support Equipment (LSE)?*
Upload a copy of a recent invoice here
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    if you're having trouble uploading your invoice please send a copy to:
    SMS: 0412 676 114

    4. Additional Information (Optional)

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    How did you hear about us?*
    What have you already done to minimise energy costs?
    Special Instructions
    Accept Terms and Conditions*
    Authority: I am providing Agent with permission to contact Energy Retailers, Energy Networks, Metering Providers and Energy Services Providers (Energy Providers) for the following purposes:

    Under no circumstances does this authority give Agent permission to enter into contracts or accept offers on our behalf.

    Data Collection including:
    • Retail electricity, natural gas, solar & demand response supply and service agreements;
    • Retail electricity, natural gas, solar & demand response service invoices and related data;
    • Electricity and Natural gas meter data;
    • Direct Metering agreements and related data;
    • Network tariff and connection information.
    Procurement of offers from
    • Energy retailers
    • Energy generators
    • Renewable energy providers
    • Other energy services providers
    Invoice validation services including:
    • Identifying and resolving billing errors
    Network Tariff Optimisation including:
    • Network tariff analysis;
    • Network tariff change requests;
    • Network tariff demand resets.
    Term: This authority is valid for the period starting 24 month prior to and ending 24 months after the date of this Letter of Authority.

    Communication: I understand that Leading Edge Energy may contact us from time to time to provide energy market updates beyond the Term of this Letter of Authority.
    Signature*
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    National Customer Code Logo - Energy Brokers, Consultants and Retailers

    Leading Edge Energy is proud to be a signatory of the National Customer Code for Energy Brokers, Consultants and Retailers.