Credit Refund Application

Use this form to request a refund from your Jacana Energy account.

Is the refund for a residential or commercial account? *

Residential

Commercial

If your credit value is under $999.99, you can also request your refund over the phone. Please phone us on 1800 522 262 during business hours.
If you’re on the Stay Connected program, it’s a little bit different. Please call us on +1800 522 262 to talk about your options.

Your details

ABN

Account number *

Account name

Position within business

Title

First name *

Last name *

Date of birth

Phone number *

Email *

Confirm email *

Choose how you want to receive your funds

I want to be refunded: *

The full balance on the account

A set amount of

To be refunded by: *

Bank transfer

Cheque (estate accounts only)

Bank transfer refunds take 7-10 working days to be credited to your account. Posted cheque refunds can take up to 21 days to be received.

Your bank account details

Financial institution name

Branch location

Account name

BSB

Account number

Your postal address

Lot no

Unit no

Street no

Street name

Suburb

State

Postcode

Authorisation

I acknowledge that I am the account holder or financially responsible contact for this account.

I acknowledge that I have the authority to act on behalf of the nominated business.

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.