SNEW: South Norwalk Electric and Water > Forms > Application for Commercial Electric Service

Application for Commercial Electric Service

Printable Form, Commercial Electric Service Application Form (PDF)

Date of Application:*
Date Format: MM slash DD slash YYYY
Date Service Requested:*
Date Format: MM slash DD slash YYYY
Activation Date:*
Date Format: MM slash DD slash YYYY
Applicant Type*
- Tenant
- Owner
Company
Company's Name*
Service Address*
Street Address Address Line 2 City State ZIP Code
Company's Billing Address(If different then Service Address)
Street Address Address Line 2 City State ZIP Code
Billing Contact Person Information
Title*
Name*
First Middle Last
Phone Number*
EXT.
Fax Number
Email*
Officers of Company*
Title Name Phone Number EXT.
BUSINESS
Select a business that applies to you.
- Sole Proprietorship:
- Partnership Or Limited Partnership (LP) (LLC) (LLP) (PA) Trust or Estate
- Corporation (Inc), Tax-exempt or other exempt business entity
Social Security Number:
OR
Employer I.D. Number:
Business Owner's Name on IRS Records:
Name on IRS Records:
Please read this section carefully!
Applicants must provide a copy of their lease, closing, or letter from owner. All individuals listed on the lease are required to sign the application form and are considered customers of SNEW.
All applicants must provide at least one of the following identification documents: Connecticut Drivers License, State of Connecticut Photo ID, Passport, Immigration and Naturalization Service Documentation or a Social Security Card with matching Official Photo ID.
The applicants for electric service agree to abide by and be governed by the rules, regulations, policies and practices of the South Norwalk Electric and Water currently enforce and as they are subsequently modified by the Second Taxing District Electric Commission.
In order to limit your liability, you the consumer will be responsible to notify South Norwalk Electric and Water in writing prior to termination of service.
Authorization*
- I/We the undersigned , hereby apply to South Norwalk Electric and Water for utility service at the above address and agree to be JOINTLY AND SEVERALLY LIABLE for payment for such service. (NOTE "Jointly and Severally Liable" means each applicant is personally and individually responsible for payment of the entire bill, and not merely that portion of the bill).
  I/We have read this application prior to signing it and understand its terms and conditions. I/We will follow all applicable rules and regulations.

Title	Name	Phone Number	EXT.

Application for Commercial Electric Service

Company

Billing Contact Person Information

BUSINESS

Please read this section carefully!