新界沙田安麗街六號沙田中心十三樓

13/F, Shatin Centre, 6 On Lai Street, Shatin, N.T.

Tel. : ( 852 ) 2678 2678
Fax : ( 852 ) 2678 6368
CONFIDENTIAL
Website : http://www.clponline.com.hk

APPLICATION FOR TERMINATION OF ACCOUNT

NOTES: 1. This request is to be made, at least TWO full working days in advance, by the registered customer or bona fide holder of
ALL relevant deposit receipt(s).
2. The bona fide holder of ALL relevant deposit receipt(s) must produce such receipt(s).
3. This form should be mailed to CLP Power Hong Kong Limited, Record Office, 13/F, Shatin Centre, 6 On Lai Street, Shatin,
N.T. or submitted to any of our Customer Services Centres, or transmitted by FAX 2678 6368.
4. Termination of account should not be treated as a request for the removal of this Company’s equipment.
5. To ensure that the premises electrical installations are safe after account termination, please turn off your main switch
under safe circumstances.
Please ‘9‘ where appropriate

ACCOUNT NO. NAME OF REGISTERED CUSTOMER

- -
SUPPLY ADDRESS

POSTAL ADDRESS

Terminate account on / /
DATE MONTH YEAR

DEPOSIT REFUND
Electronic Fund Transfer (EFT) - I attach a duly completed form and copy of passbook (only the page with bank account no.
printed) or statement of the bank account to be credited.
[ NOTE : The bank account must be under the name of the Registered Customer if the
OR original deposit receipt is lost.]

Bank Account Name Bank Account No.

Cheque in favour of

Registered Customer
Name of bona fide holder of ALL relevant deposit receipt(s)

Please Note : If the registered customer deceased, please attach a complete Letter of Indemnity (Form D) and copy of Death
Certificate / Letter of Administration with this application form.

ORIGINAL DEPOSIT RECEIPT(S) RETURN Receipt No. Amount ( $ )

(ONLY SUITABLE FOR OPEN ACCOUNT ON OR BEFORE YEAR 2004)

Original deposit receipt(s) is/are duly endorsed and enclosed for refund by cheque to the
above postal address
Original deposit receipt(s) will be duly endorsed and submitted to your Customer
Services Centre for refund [NOTE : Cheque will be sent after Final Bill is issued )

Loss of deposit receipt(s) - I / We, the registered customer(s), have duly

completed a Letter of Indemnity (Form L) as
attached to this form. TOTAL ( $ )
(NOTE: Letter of Indemnity can be obtained from Customer Services Centre or downloaded from http://www.clponline.com.hk)

APPLICANT’S NAME IN BLOCK LETTERS REGISTERED CUSTOMER’S / APPLICANT’S SIGNATURE OR STAMP

(If different from registered customer) (Company’s Stamp To Be Accompanied By Signature)

PIN / BRC NO. or HKID ( for non-registered CONTACT TEL. NO.

Customers only )
DATE OF APPLICATION:

FOR OFFICE USE ONLY

REQUEST RECEIVED BY FMR / REM / CN C. S. NO. EFFECTIVE DATE

RECORD
OFFICE INITIAL & DATE
ON INPUT
PA RECORD MADE
ACTION INITIAL & DATE
CREDIT
CONTROL

中華電力有限公司 S1800A (10/09)

CLP Power Hong Kong Limited