The Unknown

METER DEPOSIT REFUND

APPLICATION FORM

(For Active Contracts)

\ Service Identification Number (SIN): _________________________

 Registered Customer  Legal Heir  Successor-in-Interest

Date: ____________________

CLAIMANT INFORMATION The claimant shall refer to the Registered Customer (RC), Legal Heir if RC is deceased or Successor-in-Interest. Claimant’s Name Please indicate if claimant is the: Contact Information Service Address Representative (If Applicable) Relationship to Customer Contact Information

REFUND INFORMATION Mode ( ) Refund in Cash or Check  Cash (≤ P4000)  Check (> P4000) ( ) Application to Unpaid Bills, Net Amount for Refund, if any  Cash (≤ P4000)  Check (> P4000) ( ) Credit to Future Bills (Pre-Payment) ADDITIONAL INFORMATION if service is subject to a Creditable Withholing Tax (CWT) on Interest Following the provisions of BIR Revenue Regulation No. 2-2009,

Residential and General Service customers whose monthly electricity consumption exceeds 200 kWh as classified by Meralco and all Non-Residential Service customers are subject to a CWT on Meter Deposit Interest.

Tax Identification Number (TIN):

Mailing Address: This shall refer to the address where the Claimant prefers to receive correspondences.

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House/Bldg no.

Street Name

__ __ __ __ __ __ __ __ __ STATEMENT OF INTENT

Subdivision/Barangay

City/Municipality

ZIP Code

I hereby apply for a refund of my Meter Deposit under my electric service contract with the above-stated Service Identification Number (SIN). I understand and agree that the amount to be received/applied to my unpaid obligation and/or future billings represents the principal amount of my meter deposit and accrued interest, net of Creditable Withholding Tax (CWT) if applicable. I attest to my right and/or authority to claim the refund, and I agree to hold Meralco free and harmless from any and all liabilities arising from or in connection with the Meter Deposit upon...