Transcription of RESIDENTIAL APPLICATION FOR ELECTRIC SERVICE
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RESIDENTIAL APPLICATION FOR ELECTRIC SERVICE
Deposit Amount $_____(if applicable)Date Of APPLICATION _____Building Permit # _____(if applicable) Required for New MetersDate SERVICE is Required *_____RESIDENTIAL APPLICATION FOR ELECTRIC SERVICEThe ELECTRIC SERVICE requested for this purpose is for RESIDENTIAL NAME: (1) _____ADDITIONAL CUSTOMER: (2) _____SERVICE LOCATION: _____ House # (Lot #) Street Apt # City / Town ZipMAILING ADDRESS: _____(if different from above) House # (Lot #) Street Apt # City / Town ZipCUSTOMER PHONE: ( _____ ) _____ OTHER PHONE: ( _____ ) _____PLACE OF EMPLOYMENT _____ WORK PHONE: ( _____ ) _____Premises for ELECTRIC SERVICE is: Owned or Rented by Customer / Business Landlord s Name: _____SS #: (1) _____ SS #: (2) _____By signing and submitting this APPLICATION for SERVICE , the Customer ( Account Holder) agrees.
TMLP Service Application Form Local Information Temporary Service Permanent Service Service For: Resident Commercial Industrial Municipal Hot Water: Electric Oil Gas Wood Propane Other _____
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