Request for New Service or Service Upgrade Form Home » Request for New Service or Service Upgrade Form Please complete and submit this form for any disconnect/reconnect, upgrade, temporary and new service request.Customer Name:(Required)Customer Service Address:(Required)Customer Phone #:(Required)Email:(Required) Contractor/Electrician:(Required)Phone:(Required)Contact Name:(Required)Email:(Required) Mailing Address:(Required)Please note a Connection Agreement Form will need to be completed for all New Services.Service Request DetailsService Details (Check One):(Required) New Service Service Upgrade Temporary Service Panel Change Service Type (Check One):(Required) Overhead Underground Anticipated Demand Load:Existing Service:Amps:Volts:Phase:Wire:Proposed Service:Proposed Amps:(Required)Proposed Volts:(Required)Proposed Phase:(Required)Proposed Wire:(Required)Preferred In - Service Date:(Required) MM slash DD slash YYYY Metering Type:(Check One) Single Meter Multiple Meters # of Meters to be Installed:100A or Less:101A to 200A:More than 200A:Do you have plans or drawings available? Yes No If you have plans or drawings, please upload a copy.Accepted file types: pdf, jpg, gif, png, Max. file size: 20 MB.Comments:Name:(Required)Title:Date:(Required) MM slash DD slash YYYY Signature(Required) I agree.
