Update My Details

1Your Details > 2Change Request > 3Acknowledgement
Complete this form if you would like to change your account name or update your contact information as an account holder or authorised person for this property.

Fields marked with * are required fields.

This form is not printable.
What would you like to update? *
My Name My Postal Address My Telephone Number My Email Address
Supporting Documentation

If you are updating your name you are required to provide one of the following documents along with this form. You can upload these documents as images or PDF:

• Updated Drivers Licence or Medicare Card

• Births, Deaths & Marriages – Change of Name Certificate, Marriage Certificate, Birth Certificate
Your Details
I am: *
The Account Holder An Authorised Person
I am acting on behalf of: *
An individual An organisation
Organisation Name: *
Position title in organisation: *
Name on Account: * First Middle Last
If you are changing your name please use the name currently on the account.
Date of Birth: * / DD / MM YYYY
Contact Number: *

Please Note: Do not enter spaces between digits.
Form of ID: *
Drivers Licence Medicare Care Card Passport Number Organisation ABN
Drivers Licence / Medicare Card / Passport Number / Organisation ABN: *

Coliban Water respects your privacy and will only collect and use personal information for legitimate purposes. Drivers Licence, Medicare Card or Passport ID numbers are used to identify individuals within our databases to ensure accounts are issued to the correct individual. Coliban Water is bound by and committed to the Victorian Information Privacy Act.
Email Address:

Enter your email to receive a confirmation notification after completing this form.
Is this a joint account? *
Yes No
Joint Account Holder
Joint Account Holder's Name: * First Middle Last
Date of Birth: * / DD / MM YYYY
Contact Number: *

Please Note: Do not enter spaces between digits.
Email:
Form of ID: *
Drivers Licence Medicare Card Passport Number
Drivers Licence / Medicare Card / Passport Number: *

Coliban Water respects your privacy and will only collect and use personal information for legitimate purposes. Drivers Licence, Medicare Card or Passport ID numbers are used to identify individuals within our databases to ensure accounts are issued to the correct individual. Coliban Water is bound by and committed to the Victorian Information Privacy Act.
Account Details
Coliban Water Account Number: *
Maximum of 13 digits allowed. Currently Entered: 0 digits.
Please Note: Only enter numerals- Do not enter hyphens in between.
Property Address: *
Street Address Address Line 2 Suburb State / Territory Post Code Country

Update My Details

Update My Details

Supporting Documentation

Your Details

Joint Account Holder

Account Details