Commercial Electricity Connection Affidavit Form

Commercial Electricity Connection Affidavit Form
Please complete all sections to request a new commercial electricity connection. Ensure all information is accurate and up to date.
Business Name
Business Type
Business Contact Person Name
First NameLast Name
Contact Email Address
example@example.com
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Service Address (where connection is needed)
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Requested Connection Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Purpose of Electricity Connection
Estimated Power Requirement (kW)
Authorized Representative Signature
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