Form Customer Refund

ACCOUNT HOLDER INFORMATION

Select the refund application date on the calendar below (Todays date)

Full name and surname or business name (required)

Full ID number or business registration number (required)

Full VAT number (if applicable)

Contact email address (required)

Alternative contact email address (required)

Contact number (required)

Alternative contact number (required)

Please click and select the reason for your refund BELOW.

I was double debitedI paid for installation, but the installation failedI have credit on my accountOther reason

If you selected "Other reason" please let us know why below

REFUND BANKING DETAILS:

Bank Name (required)

Branch Name (required)

Branch Code (required)

Bank account holder name(required)

Bank account type(required)
SavingsChequeTransmission
Bank account number(required)

I have read and accept the terms and conditions (tick check box)