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2. We will review your request and respond to you as soon as possible during our normal business hours of 8 a.m. to 5 p.m. Monday through Friday. Do not use this form to request new residential electric service.
4. Your Name
6. First Name*
7. Middle Name
8. Last Name*
12. Name on Account (If Different than Above)
14. First Name
15. Middle Name
16. Last Name
20. Account Number
    Please supply account number if you are a current customer.
24. Services You Are Requesting

    1. Automatic Bank Draft
    2. Billing Issue
    3. Budget Billing
    4. E-Bill

    1. Letter of Credit
    2. Meter Re-Read
    3. Payment Arrangement
    4. Reconnect Service (Payment Made)

    1. Report Energy Theft
    2. Stop Utility Service
    3. Transfer Utility Service
    4. Other (Provide Details in Comments Box)

    At least one must be selected.
    
    Please provide any necessary details about this service request in the "Additional Comments" box.
28. Dates
    If you are requesting a disconnect, reconnect or transfer of service, please provide dates on which you want this to take place.
30. Disconnect Date
    Disconnect Date
31. Reconnect/Start Date
    Reconnect/Start Date
35. Current Service Address
37. Street*
38. Apartment
39. Zip Code
43. New Service Address (If Transferring Service)
45. Street
46. Apartment
47. Zip Code
51. Mailing Address (if Different Than Your Service Address)
53. Street
54. Apartment
55. P.O. Box
57. City
58. State
59. Zip Code
63. Contact Information
    2 Phone Numbers Are Required
65. Home Phone
66. Cell Phone
67. Work Phone
68. Other Phone
70. Please Select a Preference

    1. Home

    1. Cell

    1. Work

    1. Other
72. Email Address
73. Please Confirm Your Email Address
77. Premise Information
79. Will someone need to gain access to your yard for this service request?

    1. Yes

    1. No
81. Do you have a dog in the yard? (Needed for employee safety.)

    1. Yes
    2. No
85. Note: If your Customer Service Request needs to be completed within 24 hours, please call 972-205-2671.
87. Additional Comments
Leave This Blank:


89. 1. Receive an email copy of this form.
90. Email address

    This field is not part of the form submission.

91. Submit

* indicates a required field