Start Service for Property Owners

Name: Start Service for Property Owners
SKU: 1315
Price: 30.00 USD
Availability: InStock

$30.00

$

First Name *

Middle Initial

Last Name *

Date of Birth *

Email *

Phone *

Service Address *

Is your billing address the same as your Service address? *

Yes

No

Billing Address *

This application is for the following service: *

Residential

Commercial

Will this be a joint account? *

No

Yes

Previous Home Address *

Name of Previous Electric Company *

Are all residents of household 65 years of age or older? *

No

Yes

Is electricity operated life-support equipment to be used in this residence? *

No

Yes

Business Name *

Business Phone *

Previous Business Address

Name of Previous Electric Company

Co-Applicant First Name *

Middle Initial

Last Name *

Phone *

Email *

Which name do you want on your bill? *

Applicant Name

Co-Applicant Name

Both

Start Date *

CONFIRMATION
By submitting this form, I confirm that this application has been prepared or examined by me. Under the pains and penalties or perjury, I declare that to the best of my knowledge and belief, it and all accompanying documents and statements are true, correct and complete.

Category: Administrative Fees

Start Service for Property Owners

Recent Posts

MERRIMAC MUNICIPAL LIGHT DEPARTMENT