Residential Application for Service

SUBJECT TO RULES AND REGULATIONS
OF THE MUNICIPAL SERVICES COMMISSION

Since consumption is billed after use, deposits may be required to complete the application for service and before service is turned on. There is a $10.00 fee to cover the cost of a credit report per applicant which will be charged on your first bill. Deposits are based on the applicants credit score and will be held for a minimum of 12 months from the date the deposit is paid in full. After that time, if satisfactory credit has been established, the deposit will be credited to the utility account. MSC reserves the right to reassess and charge deposits based on customer's payment history at any time.

Please allow up to 3 business days to process your application.

Services Required - select all that apply*

ElectricWater

Date Service to Start*

Date

Address where service is to be established*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Will you own or rent the premises? - If you are renting you will be required to provide a copy of your lease.*

For Renters only - Upload a copy of your lease. At a minimum we need the first page showing the names and term of the lease, the page that stipulates the you are responsible for utilities, and the signature page.

Primary Applicant's name*

First NameLast Name

Home Phone Number*

Please enter a valid phone number.

Cell Phone Number

Please enter a valid phone number.

Primary Applicant's Email*

example@example.com

Primary Applicant's Driver's License or State Issued ID*

Co-Applicant's Name

First NameLast Name

Co-Applicant's phone number

Please enter a valid phone number.

Co-applicant's Email

example@example.com

Co-Applicant's Driver's License or State Issued ID

How would you like to receive your monthly utility bill?*

If you selected e-billing above, please enter the email address you want the bill sent to.

example@example.com

If you are requesting mailed bills and your mailing address is different than the service address (i.e. PO Box), enter where the bill should be mailed to.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Does a member of the household have a medical condition which requires emergency restoration if electric or water service is interrupted?*

YesNo

Condition

Once MSC has received your application, applicants will receive a phone call from MSC's customer service department requesting your social security number to enable them to run the required credit report and let you know what the required deposit will be for your account (if your account requires one).

__________________________________________________________________

Agreement For Service

The undersigned agree(s) to be (jointly and severally) financially responsible for any and all charges and costs associated with the electric and water services provided by the MSC. Full details of MSC Rules and Regulations are avaliable at: www.newcastlemsc.delaware.gov/tariff/.

Applicant's Signature*

Co-Applicant's Signature