If you are moving within our service territory and need to discontinue the service at one address and begin service at another address, please complete this form.

Fields indicated with * below are required

Account Number	*
First Name	*
M Initial
Last Name	*
Address at which you receive electric service	*
City	*
State	*	- - Choose One - - Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip	*
Date to Discontinue Service
Did you	*	Own Rent
If Renting, provide name and address of landlord.
If you are selling the property, please provide the name of the new owner, or the name and phone number of the real estate agent.
New address at which you receive electric service	*
City
State	*	- - Choose One - - Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip	*
Date to start new service	*
Will you	*	Own Rent
If Renting, provide the name and address of landlord
Contact information if we have any questions:
Daytime Phone Number	*
E-mail Address	*
RE-enter E-mail Address	*
Comments	*
Security Code	*