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Application For Service

Disclaimer: After completing this application, you will receive a call back within 48 hours of the application submittal. This is only an initial request for service. Other requirements must be satisfied prior to account creation. A signed customer contract is also required for account creation. This request will be processed within 5-10 business days. You will be contacted prior to this request being fulfilled.
Type of account:
What is the address for which you are requesting new services:
House Number:
Street Prefix:
Street Name:
Street Name Suffix:
Street Direction:
Apt/Ste/Unit:
Unit Number:
City:
State:
Zip Code:
PO Box:
Which business day would you prefer services to begin:
Are you an existing customer with the DPU?
Account number and/or previous address:
Full legal name as it appears on your driver's license or W9 Account:
Are you a tenant of this property:
Home phone number:
Work phone number:
Property Owners Name:
Email:

Date you would like initial meter reading to occur:
Mailing Address (if different from service address):
House Number:
Street Prefix:
Street Name:
Street Name Suffix:
Street Direction:
Apt/Ste/Unit:
Unit Number:
City:
State:
Zip Code:
PO Box:
Is there meter access (if dogs, locked gate, or security alarm restrict access to meters, please provide instructions to gain access):
Property Owners Address:
House Number:
Street Prefix:
Street Name:
Street Name Suffix:
Street Direction:
Apt/Ste/Unit:
Unit Number:
City:
State:
Zip Code:
PO Box:
Property Owners phone number:
Social Security Number or Federal ID Number:
Your Employer:
Employers Address:
House Number:
Street Prefix:
Street Name:
Street Name Suffix:
Street Direction:
Apt/Ste/Unit:
Unit Number:
City:
State:
Zip Code:
PO Box:
Employers Phone Number
I do confirm that the information provided within this form is accurate and I do recognized that by checking this box I am bound by law:
Disclaimer: After completing this application, you will receive a call back within 48 hours of the application submittal. This is only an initial request for service. Other requirements must be satisfied prior to account creation. A signed customer contract is also required for account creation. This request will be processed within 5-10 business days. You will be contacted prior to this request being fulfilled.
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