Report Electrical Outages – Klerksdorponline

This form is only for electrical outages and will only be forwarded to the Electrical Department via Email. !!ALL FIELDS ARE REQUIRED!!

NAME AND SURNAME*
YOUR CONTACT NUMBER*
No space or other special characters. Only numbers.
YOUR EMAIL*
THE ADDRESS WHERE THE ELECTRICITY IS OUT*
STREET NR STREET NAME AREA
SHORT DESCRIPTION*
IE: From what time is the electricity off, and what happened.
TODAYS DATE*
TIME SUBMITTED*
What is the time now?

HH :

MM