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Electric Resale Disconnect Request Form
Electric Resale Disconnect Request Form
Please use this form to request the discontinuation of your electric service.
If you see this don't fill out this input box.
Customer Information
Your Name
Forwarding Address
Forwarding Phone Number
Location of Service
Property Owner's Name
Apartment/Trailer #
Location of Dwelling
Account Information
Electric Account Number
Date disconnect is to be effective
Disconnects are not made on Saturdays, Sunday, or Holidays.
By submitting this form, you certify that all of the information on this form is true and complete to the best of your knowledge and that you are the customer named above.
Submit
Cancel
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