Applicant

First Name *

Last Name *

Address *

Email *

Email

Confirm Email

Phone / Mobile Number *

Alternative Phone Number

ID Number / Passport Number / Driver's License / Chamber of Commerce Number *

Notes
• A local identification document (sedula, passport or driver's license) is required.
• Non-residents are required to have a valid residence permit or an admission by operation of law (“toelating van rechtswege”) when applying for a new service requests.

Request the supply of

Requests the supply of: *

Electricity
Water
Electricity & Water

New or existing connection *

New Connection
Existing Connection

Postpaid or Prepaid System *

Postpaid System
Prepaid System (Pagatinu)

Premises details

Address of the premises for supply *

Is there an existing meter at the premises? *

Yes
No

Address to where the invoice should be send

Would you like to view your invoice online (MiKuenta) and receive it via email only? *

Yes
No

Would you prefer automatic bank payment for your Aqualectra invoices? *

Yes, I agree
No

User acceptance disclaimer

User Acceptance Disclaimer

Click here to download General Terms and Conditions

Applicant Signature *

Statement of the owner of the premises

First Name Owner *

Last Name Owner *

Address Owner *

ID Number Owner *

Phone / Mobile Number Owner *

Email Owner *

Email

Confirm Email

Owner Signature *

Notes
• If the owner of the premises can not personally be present, a power of attorney (machtiging) is required for the validation process of the service.

Disclaimer

Please click to make an appointment

FAQ

0800-0135

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Application for a new electricity / water connection