REQUEST TO BPL FOR PAYMENT ARRANGEMENT Please select your desired plan Pay 25% of arrears now and balance of arrears to be paid over 12 monthsPay 50% of arrears now and balance of arrears to be paid over for 6 months Name of Account Holder (required) Billing Address Telephone Contact Cellphone Contact Your Email (required) Account Number Meter Number Agreement I agree that upon signing this payment arrangement, I will be responsible each month for timely payment in full of my monthly bill in addition to also paying the agreed payment plan amount. In the event that I default in paying the monthly bill and/or the payment plan amount due under this agreement, the payment plan will automatically be cancelled and payment in full of the balance due on the payment plan amount plus the monthly billing will be required from me. I understand that payment of the deposit (either 25% or 50% of outstanding arrears) is required to trigger this agreement. I understand and agree that failure by me to remit payment in full of the balance of the payment plan amount owing by me and/or the monthly billing will result in my immediate disconnection. I agree