Use this form if you are a residential customer and you are applying for:

  1. Connection of electricity: You want to get electricity connected at your home address.
  2. Disconnection of electricity: You want your electricity disconnected, but do not require reconnection at a new address.
  3. Move-out/Move-in: You are moving and want to disconnect electricity at your old address and reconnect at your new address.

Required fields are marked with an asterisk (*)

1. What service do you require ?

Select one of these three options: *
Is the Connecting property used for residential or commercial purposes?
(e.g. residential with home business)

Connections and disconnection may take up to 7 business days to be processed.

If your request is URGENT continue to complete the online form with the next available date and call and provide your reference number with your amended date to prioritise your service request.

Connection and disconnection fees apply. For information visit the Pricing and Tariffs page.

2. Your details

Preferred delivery method (bills and correspondence)
Form of identification

If you don't have any of these forms of ID, please contact us on 1800 522 262 for further assistance.

The name on the concession card must match the name of the Jacana Energy account holder.
Are you a Public Benevolent Institution registered with the ACNC?

3. Additional authority on the account

Would you like to add an additional authority on to the account?
Account authority details
Level of authority
Part A
Part B

4. Disconnection address

Disconnection details
Disconnection Address
Jacana Energy does not schedule disconnection services during weekends or public holidays. If you select a public holiday or a weekend, your request will be scheduled for the next business day. If your request is needed in the next 7 business days, please call us at 1800 522 262.
Please note: Instructions will be taken into consideration but not guaranteed.

If there are access restrictions to your property such as locked gates or unrestrained dogs, the disconnection will not take place and you will be liable for usage and supply charges until access is granted.
 

Postal address where to send your final bill

Note: We will attempt to send your final bill by email first if you have selected this option as your preferred delivery method; however please also provide a postal address to forward any future Jacana Energy mail.

Please fill in at least one of the following fields: Lot no, Unit no or Street no.

5. Connection address

Connection details
Is the property a newly built home?
(Mandatory for new developments / newly built homes)
Connection address
Jacana Energy does not schedule connection services during weekends or public holidays. If you select a public holiday or a weekend, your request will be scheduled for the next business day. If your request is needed in the next 7 business days, please call us at 1800 522 262.
Please note: Instructions will be taken into consideration but not guaranteed.

If there are access restrictions to your property such as locked gates or unrestrained dogs, the connection will not take place. You may still be charged a contractor call out fee.
 

Does the property have solar panels?
Will anyone living at this address use an electrical device that assists with a life-threatening medical condition? (Life support)

By selecting YES, you confirm that someone living (or will live) in this property has a life-threatening condition that requires uninterrupted electricity supply to operate equipment a registered medical practitioner certifies is needed for life support.

Click here for full details.

You will be listed temporarily on our Life Support Customer Register. We will send you a Medical Confirmation Form or you can download it here. The form needs to be signed by your medical practitioner and returned to us no later than 21 business days from when you receive it.

Failure to provide a completed Medical Confirmation Form may result in your service address being delisted from the Life Support Customer Register.

5-B. Life Support Details

Life support
Must be on or after connection date.
Type of life support equipment:

6. Acceptance

By submitting this application, you:
Please fill in our business Move In/Move Out form.
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