Horizon Power :: Online Claim Form

* Indicates a mandatory field.

1. Applicant Details

(please note eligible claims are only payable in the name of the account holder at the affected premises)

Horizon Power Account Number *

Name as shown on the Account *

2. Address of Property Affected

Postal Address *

Town / Suburb *

Postcode *

Contact Telephone

3. Contact Details

Title *

First Name *

Surname *

Postal Address *

Town / Suburb *

Postcode *

Contact Telephone *

4. Interruption Details

Date power went off *

e.g dd/mm/yyyy

Approx time power went off : e.g 08:10

Date power came on *

e.g dd/mm/yyyy

Approx time power came back on : e.g 10:10

Application Declaration

Terms and Conditions - this claim is made because I was not notified of a planned power interruption at least three days in advance of work being carried out to the electricity supply to my property. By signing and submitting this claim form, I confirm:

That the information in this claim form is true and correct.
That Horizon Power does not admit any liability for making any payments under this.
I have not previously applied for payment for the same Interruption at the same address.

I have read and understood the eligibility criteria and terms and conditions of the Planned Power Interruption Claim and agree to abide by the schemes eligibility criteria and terms and conditions.