Energy Revolt

Information

This form generates a pdf file at the end.

you do not have an activated Smarty intelligent meter (SAG);
you wish to subscribe for several PODs and/or you are not on the low-voltage network.

To prepare for your subscription, make sure you have:

If you are already an Energy Revolt customer, we invite you to log on to your customer area, where information will be loaded automatically.

It is a contract for a

Ms.

Mr.

Non-binary

Name

Firstname

G.S.M. ( Check the prefix and number you have entered, as this information will be used to sign the contract.)

Date of Birth

E-mail

Sending invoices

Copy of your identity card ( to upload multiple files, select and hold down the Ctrl key) The maximum authorised size is 8 MB

Name

N° RCS

Forme juridique

N° TVA