We will use the information you provide on this form to asses your suitability for a repayment plan.
Whilst we aim to accommodate your request where possible, we may need to contact you further in the following instances:
- to discuss your preferred repayment terms and work with you to agree a suitable plan
- to set up a Direct Debit where you have requested this but do not already have a Direct Debit in place
- to discuss any further support that may be available to you
If you pay for your energy via a Pay As You Go (PAYG) or Prepayment meter you do not need to complete this form.