Was your document accepted?
You made this document on this device before. Your answer helps us improve the models; only the document's name is sent.
Thank you! Your answer helps.
Thanks for your answer. If something in the model should change, tell us:Report a mistake in this document
What you need
- Your details (name, ID card, address)
- The provider
- Contract number
- The bill (period, number, amount)
- The problem
- What you ask for
- Place of signing
What to bring
- A copy of the disputed bill and the last normal one
- A photo of the meter if possible
- Hand it in against a receipt or send it by registered mail
This is a standard model: check it with the administration concerned.
Frequently asked questions
Does the signature on this document need to be legalised?
No, this document needs no légalisation: signing it is enough.
What information do I need to fill it in?
Your details (name, ID card, address); The provider; Contract number; The bill (period, number, amount); The problem; What you ask for; Place of signing.
What language is it written in?
In Arabic or in French, as you choose.
What should I bring?
A copy of the disputed bill and the last normal one; A photo of the meter if possible; Hand it in against a receipt or send it by registered mail.
Is it free, and where does my information go?
It is free. The document is prepared on your device and your information is sent nowhere; you then print the PDF at any print shop for the price of printing.