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Prepaid Gas Metering
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Last name:
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Email:
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Company Details (Leave blank for personal use)
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Address Details
Physical address Line 1:
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Physical address Line 2:
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City:
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Johannesburg
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Contact Numbers
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Additional Number:
Smart Solutions
Gas usage/month kgs:
Auto Changeover Default Payment Method:
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Bank Transfer (EFT) Send POP
MyGate Secure Credit Card
Auto Changeover - Send Complete Order Reminder every how many days?:
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No Reminder
Every day
Every 2 days
Every 3 days
Every 4 days
Every week
VAT#:
Company Reg#:
Are you a Prepaid Metering customer?:
No
Yes
*
Gas Meter Serial Number:
Prepaid Smart Device Serial Number:
Are you an Auto Changeover customer?:
No
Yes
*
Total number of bottles on Auto Changeover:
---
2 x 19Kg
2 x 48Kg
4 x 48Kg
6 x 48Kg
8 x 48Kg
10 x 48Kg
12 x 48Kg
14 x 48Kg
16 x 48Kg
18 x 48Kg
20 x 48Kg
Auto Changeover Serial Number:
Your Password
Password:
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Confirm password:
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