Start Service Customer or Business NameService AddressStreetCityStateZip CodeIs Mailing Address the same as Service Address Yes NoMailing AddressStreetCityStateZip CodePhone Type Cell Phone Home PhonePhoneEmailPreviousNextTenant or Owner?- Select -TenantOwnerTenant Services ElectricServices: Electric Water Solid WasteDoes the property have a nightlight you wish to start service on as well? Yes NoDate you would like your service connected? (no same day service. 24-hour notice required.)ID Type - Drivers License | Passport/Visa | Other- Select -Drivers LicensePassport | VisaOtherID Type 2 -Social Security | Federal ID | TIN | N/A- Select -Social SecurityFederal IDTINN/AID Number - (If Not Available Type - N/A)Date of BirthPreviousNextOne Form of Identification (ex. Driver's License | Passport | Other)Choose File Second Form of Identification (ex. Social Security, Fed ID, or TIN)Choose File Copy Of Rental Lease of Sale/Property DeedChoose File Copy Of Occupancy PermitChoose File Other Documents (DAV Medical Card, VA ID, Award Letter from Social Security Administration Office)Choose File I have read and agree to the Consent Statement Previous Submit Form
