Gas application form

Small business new connections

Small business customers connecting to gas can apply online or print out and send our small business new connection form (PDF 245KB) or small business moving or switching form (PDF 245KB).

Return to small business gas information.

Please note: fields marked with * are required.

Customer details

Trading name *

Company name *

ABN *

Street address *

Suburb *

Postcode *

Is your billing address the same as your address above? The billing address is the same as above

Billing street address *

Billing suburb *

Billing postcode *

Contact person *

Position *

Phone *

Fax

Mobile *

Email *

Additional contact details for connection

Are you the landlord if not owner occupant? * Yes No

Landlord details

Name

Street address

Suburb

Postcode

Phone

Fax

Mobile

Connection information

Is this a new gas connection? * Yes No

Nominated commencement date

Date format required DD/MM/YYYY

A charge will apply to services not consuming within 90 days of connection on this date as per clause 3.6 of TasGas Networks Terms & Conditions

Appliances to be installed/converted and MJ rate.

1	MJ
2	MJ
3	MJ
4	MJ
5	MJ
6	MJ

Estimated annual load in GJ

Total connected load in MJ/h

Pressure requested

If greater than 7kpa additional information is required

Gasfitter

Company

Phone

Acknowledgement and authority to connect gas supply

I/We have the authority to make this request. I/We confirm that I am/we are the owner of the property detailed in the supply address, or I/we have obtained the explicit permission of the owner of the property to make this request, and I/ we confirm that these details are correct.
As the customer, I/we agree to abide by the TasGas Networks Residential Connection - Terms and Conditions (PDF 116KB) and associated Tasmanian Law.
I/We consent to Aurora Energy Pty Ltd providing my/our contact details to TasGas Networks for the purpose of connection and who may contact me/us directly in relation to the connection process.
I/We authorise TasGas Networks to carry out the service connection and the necessary works to the property as stated in this application form.
I/We understand and agree that Aurora Energy does not act as an agent for TasGas Networks.
I/We acknowledge that I/we have read and understood the terms and conditions contained in the Aurora Energy Gas Sale Agreement (PDF 322KB).
I/We hereby agree, without limitation or qualification, to be legally bound by, and to comply with the terms and conditions set out in the Aurora Gas Sale Agreement.
I/We understand that under the Aurora Gas Sale Agreement, I/we are entering into a 12-month agreement for Aurora Energy to supply gas.

I/We have checked that all sections on this form are complete and correct

I/We have read and accept the terms of this application