Online forms

Supply interruption lodgement request form - Step 1 of 2

Please use this form to lodge your details regarding your supply interruption claim and arrange for the appropriate documents to be posted to you.

In order for us to process your request, please complete all sections of this form.

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Your contact details

First name
Surname
Postal address
Suburb
State	Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
Postcode
Email
Daytime telephone number

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Account and address details of where interruption occured

Aurora Energy account number where the loss of supply occurred (your account number can be found in the top right hand corner of your Aurora bill)
Is this account in your name?	Yes No
Address where the supply interruption occurred	The address is the same as above.
Street address
Suburb
State	Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
Postcode

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Details of the supply interruption

Date of the event	12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 19951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020
Did the power go off?	Yes No
List of items lost:
Description of the event:

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What would you like from us

Please indicate the type of correspondence that you would like from Aurora Energy

A letter to make a claim against your insurance company A claim form from Aurora

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