1. Client Identification

Name*
VAT*
Email*
Phone Number*

Address

Street*
Floor
Postal Code*

2. Consumption Location Data

(if different from holder)
Street
Postal Code

3. Contract Type

CPE*

4. Contract Data

Contract Power*
Type of Supply
Fare Category*
Hour Cycle (KVA)
Offer a contract

5. Billing and Payment Method

Billing Type*
Sending Email (if different from previous)
Type of Payment*
IBAN
NIF/NIPC
Name/Company
In the case of direct debit, the payment holder authorizes payment by direct debit from the account mentioned above for the invoices issued by Lusiadaenergia, S.A.

6. Attachments

Proof Of Address*
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*METHODS OF PROOF OF ADDRESS:

According to number 2 of Article 21 of the Commercial Relations Regulation, the proof of address documents considered for the execution of an electricity or natural gas supply contract are as follows: • Invoice from the previous supplier dated within the last 3 months. • Proof of address documents issued by the Tax Authority (AT). • Rental contract or other valid title for occupancy of the property, or equivalent.

IBAN Proof
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Signed Membership Form*
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Max Attachments 1.