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Apartment Simplified Application Plan
Please select type of service:
*
Please Select Service
Electric
REQUESTED DATE TO START SERVICE:
*
(mm/dd/yyyy)
Turn on orders may be delayed during storms or other times
when we experience a high number of calls.
Applicant's full name:
*
SSN/TAX ID:
*
Service address:
*
Apartment/Lot/Unit#:
City:
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State:
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ZIP code:
*
Date of birth:
*
(mm/dd/yyyy)
Identification:
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Driver's license/State ID
Passport/Visa
*
Number:
*
State/Country:
Contact telephone number:
*
Applicant e-mail address:
Employer:
Work telephone:
Is mailing address different than service address?
No
Yes
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