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  Download Survey Form
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Customer Survey Form
   
 

All fields are required. Please enter N/A for fields that are not applicable to you.

Customer Name:

Get your customer name from your bill

Number of Family Members:

   For Residential Customers Only

Customer Number:

    Get your Customer Number from your bill

CNIC Number:

-- Customer CNIC

Do You Want to Change Customer Name:

Yes

No

Customer Type:

Commercial

Industrial

Residential

Occuption:

Govt. Service

Private Service

Business

Gas Pressure:

Low

Normal

 

Meter Reading:

Regular

Irregular

 

Flat/House/Plot:

Owned

Rented

 

Flat No.:

 

Example: A-38

House/Plot No.:

 

Example: B-69

Flat/Plot Size:

 

Example: 200 Square Yards

Floor No.:

 

Example: 5th Floor

Flat/House/Plot Name:

 

Example: Qamar House or Waheed Appartments

Street/Road Name:

 

Example: Shahrah-e-Shershah or Street 15 Off Khayaban-e-Ittehad

Survey/Sector:

 

Example: Survey 333 or Sector 15-A

Block:

 

Example: Block 8

Phase:

 

Example: Phase IV

Minor Location:

 

Example: Madina Colony or Buffer Zone

Major Location:

 

Example: North Karachi

Postal Code:

 

Example: 15500

Phone Number:

 

Example: 8256325

E-Mail:

 

Example: younuskhan@hotmail.com

Town:

 

Example: Gulberg Town

Union Council:

 

Example: UC-4 (Ancholi)

No. of Kitchens:

 

For All Customers

No. of Appliances:

 

For Commercial & Industrial Customers

No. of Water Heaters:

 

For All Customers

    

 
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