Buy Prepaid Electricity Online

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Company Details:

Company Name

Company Registration Number

Physical Address

VAT Number

Company representative / contact person:

Name and Surname

Cell number

Confirm Email

Landline/alternative contact number

Language preference

English Afrikaans

Payment Detail:

Prior to payment, would you require a Proforma Invoice?

Yes
No

VAT Invoices are only supplied after payment is made and product is delivered. Would you require a VAT Invoice?

Yes
No

Would you like the Proforma Invoice/VAT Invoice to be sent to an alternative email address (in addition to the primary email address)? Specify the email address here:

Preferred Bank

Promotional Code

Prefered payment method

Electronic Funds Transfer (EFT)

Credit Card

Password Information:

Password

Confirm Password

I have read and accepted the T & C's

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