ACKNOWLEDGEMENT OF PRIOR CONSENT
Name
(Required)
First
Phone
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Email
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Address
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Rep Name
Acceptance
I confirm that, prior to contact from the below sales representative, I gave my express consent to being contacted by the energy retailers agent below for the purposes of a discussion and possible negotiation of a supply and sale contract for electricity and/or gas.
Authorized Person Signature
(Required)
Signature Date: 18 May 2026
Signer IP:216.73.216.62