Stop electric service

Stop service

Service address

Date to stop service at above location

Account information

Account #

Name (first and last)

Primary phone #

Email address

Forwarding address

Address

City/Town

State

ZIP/Postal Code

Reason for stopping service

I am a renter moving out

I am the property owner and do not want service at this time

The above property has sold and is transferring ownership

Landlord information

Landlord's name

Landlord's phone #

I understand there is a $100 disconnect fee that I agree to pay

There will be a $100 reconnect fee when service is reconnected.

New owner or realtor name

Please list the new owners or the realtor, if the new owner is not known

New owner or realtor's phone #

Member's signature

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