SNEW: South Norwalk Electric and Water > Forms > Customer Authorization Form, Electric Operations

Customer Authorization Form, Electric Operations

Billing Name and/or Address Change

Account #:*
Today’s date:
Date Format: MM slash DD slash YYYY
Account Holder*
First Last
Property Address:*
Street Address Address Line 2 City State ZIP Code
Authorization*
- This is to certify, I authorize South Norwalk Electric and Water to change the billing name and/or address on my account. I acknowledge and accept that there is a $10 fee for this service which will be placed on my account.
Change BILLING ADDRESS to:*
Street Address Address Line 2 City State ZIP Code
TELEPHONE #:*
(Important for SNEW to acquire additional information if necessary).
NOTICE:
The customer of record is responsible to change the billing name and address as appropriate. THIS FORM DOES NOT TRANSER RESPONSIBILITY FOR PAYMENT OF THE BILL TO ANYONE OTHER THAN THE CUSTOMER OWNER OF RECORD.

NOTICE: