Request a payment arrangement - Prepayment customers

The support we will offer can be a loan, a hardship support payment or a combination of the two depending on your circumstances.

Information received via this online form is processed during business hours, Monday to Friday, 8:00am to 4:30pm.

Reference Number

Your details

First name *

Last name *

Meter number Find this number on the front of your meter, under the barcode - starts with PN00

Prepayment card number (last 5 digits) *

Service address *

Email address

Phone number *

NT Concession Card number (if applicable)

Your current situation

Please select the reason for your request: *

What is the maximum amount you can afford to pay per week? * Please also consider contributions that other people in your home may be able to make to the costs of your electricity.

Do you need a once-off or ongoing arrangement? *

If ongoing arrangement - until when do you need this arrangement? Please specify a date: dd/mm/yyyy

Do you have power at the moment? *

Acceptances

By submitting this form you agree to the following terms:

I confirm that the information provided in this form is true and accurate.
I give permission to Jacana Energy to set-up a support arrangement for my prepayment meter based on the information submitted in this form.
I understand the support I will receive can be in the form of a loan, a hardship support payment or a combination of the two depending on my circumstances and as assessed by Jacana Energy.
I understand that this arrangement can be varied as required and I agree to notify Jacana Energy immediately if my circumstances change.