Information for Commercial Service Form

Account Name:
Billing Address:
Service Address:
   
Lighting  
Voltage
Amperage
Number of Phases Required
   
Power  
Voltage
Amperage
Number of Phases Required
   
Nature of Business
 
State approximate length of operation
 
If any additional load is anticipated at this location, state amount of load projected and approximate date the additional load is anticipated:
 
Electrical Contractor
Name of Company
   

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