Online announcement form

Announcement Arrival - Departure

PERSONAL INFORMATION
Name*
First name*
Telephone number*
Mobile number (Recommended in case of emergency)
E-mail address*
Subscription number (if you do not have a subscription to cancel on our network, please leave blank)
OLD ADDRESS INFORMATION
Street and number*
Locality*
Floor*
Apartment No.
Number of rooms
Departure date (inventory of fixtures)*
DD slash MM slash YYYY
Name of new tenant
NEW ADDRESS INFORMATION
Street and number*
Locality*
Floor*
Apartment No.
Number of rooms
Date of arrival (inventory of fixtures)*
DD slash MM slash YYYY
Name of former tenant
I authorise Yverdon-les-Bains Énergies to provide me with information:
- via my email
- via SMS

Last updated: March 29, 2019 at 3:46 pm