Non-Subsidised Form

Fill out this Application Form if you wish to apply to receive 150 Non-Voting Shares in the capital of Energy Fiji Limited :
  • Please read the Offer Document.
  • Follow the instructions to complete this Application Form.
  • Type clearly in ENGLISH and in CAPITAL LETTERS
  • By completing and Submitting an Application, you appoint the Permanent Secretary (as defined in the Offer Document) as your attorney to execute a Master Transfer Form to effect the transfer of 150 Non-Voting Shares.

A ) Number of shares You are applying to recieve
B ) Enter the Account Holders Customer Number with EFL

Enter 7 digits/numbers without - or spaces

C ) Write the name of the Account Holder here. The Non-Voting Shares will be registered in this name

At least one full given name and surname is required

D ) Write the postal address of the Account Holder here

E ) Contact telephone number (daytime/mobile)

F ) Enter Email
G ) Bank Details

H ) Fijian Citizenship Details
Account Holder's Citizenship and Residential Details.
Please note that either one of Voter ID or Passport Number is required.
Voter ID Number
Voter ID Attachment

Passport Number

Passport ID Attachment

Tax Identification Number (TIN)

Enter 9 digits/numbers without - or space

TIN ID Attachment

Residential Address