1 Start 2 Complete All questions must be answered, unless marked (optional) Broker Name E-mail address to use for replying Business Name: MPAN / MPRN Please select the action that you would like to complete. - Select -Change of start dateCancellationReapplicationReturnsStatus CheckSupported Meter checksCED, EAC and Credit Checks Please only submit details for one premise per form. Additional premise should be submitted on a separate enquiry. Requested new start date: Day (optional) Day12345678910111213141516171819202122232425262728293031 Month (optional) MonthJanFebMarAprMayJunJulAugSepOctNovDec Year (optional) Year20192020202120222023 Cancellation reason: Reapplication date: Day (optional) Day12345678910111213141516171819202122232425262728293031 Month (optional) MonthJanFebMarAprMayJunJulAugSepOctNovDec Year (optional) Year20192020202120222023 Return reason: Unreturned reason: Contract submitted date: Day (optional) Day12345678910111213141516171819202122232425262728293031 Month (optional) MonthJanFebMarAprMayJunJulAugSepOctNovDec Year (optional) Year20192020202120222023 Please check your most recent status report before submitting your form What information is required? Cancellation date: Day (optional) Day12345678910111213141516171819202122232425262728293031 Month (optional) MonthJanFebMarAprMayJunJulAugSepOctNovDec Year (optional) Year20192020202120222023 Reason for request (optional) Please attach any supporting evidence that is related to your enquiry (optional) Files must be less than 2 MB.Allowed file types: gif jpg jpeg png.