New Gas Connection

Customer or Customer Representative (in case if the application is for a Company)

Full Name (as written in the Passport or Emirates ID) *

Mobile Number *

+971

Email ID *

Emirate *

Area *

Location *

Building Number *

Building Name *

Apartment / Villa Number *

Type of Establishment *

Meter Type *

Unit Type *

Company Name *

No of Rooms *

Gas Cooker Availability *

Electricity Availability *

Photo of Gas Cooker *

I agree to the terms and conditions

Your request for a new gas connection has been cancelled.

Your request for a new gas connection has been successfully submitted.

Reference Number :

Additional Details

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Residential / Business Details

Address 1

Address 2

Country *

P.O.Box Number

Bill Fax Number

Landlord Details

First Name *

Last Name *

Email ID *

Mobile Number *

+971

Landline No

Fax No

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Reference Number :

Upload Documents

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Passport Number *

Passport Expiry *

Passport upload *

Emirates ID Number *

Emirates ID Expiry *

Emirates ID (Front and Back) *

TRN Number *

TRN Expiry Date *

Trade License *

Third Party Inspection(TPI) Test Report *

Civil Defense Final Certificate/Authority *

VAT Certificate(if under company accommodation) *

Tenancy Contract/Purchase Agreement (Main page only)

Tenancy Expiry *

Please review, sign and then upload the signed Gas Service Agreement to proceed with your new gas connection request.

Gas Service Agreement

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Reference Number :

Online Payment

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Security Deposit :

Connection Fee :

Total Amount :

OR

Reference Number

Payment Receipt

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Reference Number :

Please Select the Preferred Date And Time for Gas Connection

Date *

Timeslot *

(Schedule date will be confirmed by Call Center)

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Request to Cancel New Gas Connection

Reason *

Total Refund amount :

Beneficiary Name *

Bank Name *

Bank Account No *

Swift Code

IBAN No *

AE

Email ID *

Signed Authorization Letter is required if the Beneficiary Name is different than the Customer Name

Reference Number :

Your request for a new gas connection has been successfully submitted. Our call center representative will contact you shortly.

Preferred Date :

Preferred Timeslot :

Reference Number :

Thank you for choosing our services! Your gas account has been activated. Please use the customer information below to register online.

Customer Name

:

Email ID

:

EBS Number

:

Gas Account Number

:

ONLINE Register

Reference Number :

Thank you for choosing our services! Your gas connection request has been received. Please note the reference and our call center representatives will be in touch with you shortly.

Reference Number :

Your request for a new gas connection has been successfully submitted. Our call center representative will contact you shortly.

Scheduled Date :

Scheduled Timeslot :

Meter Installer Name :