Residential Transfer for Existing Service

Residential Transfer for Existing Service

Allow three business days to process this application
Applicant Name*

First NameLast Name
Co-applicant Name

First NameLast Name
Main Phone Number*
Please enter a valid phone number.
Phone Number 2
Please enter a valid phone number.
Email
example@example.com
Applicant Photo ID

Cancelof
Co-Applicant Photo ID

Cancelof
New Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date for service to start*

MonthDayYear
Date
Services to connect*

ElectricWater
Will you own or rent the premises? *
If you are renting please upload a copy of your lease. At a minimum, the first page showing your name, the page stating you are responsible for utilities, and the signature page(s).

Cancelof
Old Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number
Date to disconnect service(s)*

MonthDayYear
Date
Services to disconnect*

ElectricWaterNone
How would you like your new bill to be delivered?*
If you selected e-billing, what email address should the bills be sent to?
example@example.com
If the mailing address is different from your new service address (i.e. PO Box) please enter it below.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Agreement

The undersigned agree(s) to be (jointly and severally) financially responsibility for any and all charges and costs associated with the electric and water service provided by the MSC.
Applicant Signature*

Clear
Co-applicant Signature

Clear
Should be Empty:

Residential Transfer for Existing Service

Agreement