A residential customer may designate a consenting person/agency to receive a copy of any disconnect notice issued. Upon written notification, the utility shall mail an additional copy of a disconnect notice to the designated person/agency.

Name(Required)
Service Address(Required)
Billing Address(Required)
Person or Agency that may be contacted prior to termination.
Name(Required)
Address(Required)
Member Consent(Required)
This field is for validation purposes and should be left unchanged.