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Account Termination Form

Registrant Name (Eng) *

Registrant Name (Chi)*

Phone *

Email

Address for termination *

Final billing address *

Customer Account No. *

Bank Name

Deposit Refund Bank Account No. *(please check carefully):

* Please fill in required information.

Service Terms and Conditions:
1. If discrepancy arises between the readings reported by customer and that recorded by our fitter during meter disconnection, the latter shall prevail.
2. Deposit refund shall be processed only after all gas charges and service fees under the LPG customer account fully settled and gas meter returned in proper.
3. Your deposit will be applied against any damage/loss of gas meter, and we will refund you the balance, if any, by bank transfer within 6-8 weeks.
4. For any disputes, IP&E GBA Limited reserved all rights.

I hereby confirm the above personal information is true and correct. I fully understand and agree the above terms and conditions.

Your Signature

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