Update the data of beneficiaries of free water


Location Information


Governorate
Wilayah
Town

Contractor Information

Contractor Name

Customer Information

First Name
Second Name
Third Name
Family Name
Civil No
GSM No
Monthly Income
Are you a Social Beneficiary class?

Primes information

Electricity Account No
PrimesType
Type of way to reach the Primes.

Services Information

No of fill in a month

Attachments

Civil ID(*)
Copy of Electricity Bill(*)
Enter Security Code (*)
1AAC2B