Apply for Commercial Service | Citizens' Electric Company of Lewisburg, PA

Name

This field is for validation purposes and should be left unchanged.

Business Name*

Legal Name of Business

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Federal EIN/Tax ID

If your account is tax exempt, please complete a tax-exemption form listing your taxable percentage and your tax exemption number issued by the state (this is different than your tax ID number). If you have multiple accounts in your name and any of them are tax exempt, please also complete a usage statement explaining the exemption reasons. If your accounts include residential properties, please complete the residential usage statement. You can email scans or photos of your completed forms to billing@citizenselectric.com. This information is required by the PA Dept. of Revenue. More information about PA Sales Tax is available at https://revenue-pa.custhelp.com/app/answers/list/c/13,109.

Phone*

Email*

Service Effective Date*

Applicant is:*

Owner
Builder
Electrician
Tenant
Other

Request is for:*

Contact Name*

First Last

Address where service is requested*

If you will be renting, name of landlord, realtor or person to whom you pay rent:

As part of the Electric Choice Program, customer information will be provided to licensed generation suppliers. This information includes your name, billing address, service address, account number and electric usage information. This allows suppliers to provide you with information about their services and makes it easier for you to take part in Electric Choice. Suppliers are required to keep your account information confidential.
PUC regulations require that we release your account and electric usage information to electric generation suppliers. If you do not want your information released please check the box below.

Do not release any information to licensed electric generation suppliers.

• To help prevent identity fraud, we will require the Social Security Number and EIN of all applicants. A Customer Service Representative will contact you at the number you provided to request this information. You can also call us at 570-524-2231 to provide this info. You may opt out of providing your SSN. Opting out will limit our ability to verify your credit history, so a deposit may be required.

• You will be advised if a cash deposit is required as a condition of receiving permanent service.

• If application is for service at a location not previously served by Citizens’ Electric, please continue on to complete the NEW CONSTRUCTION INFORMATION below.

• If you are applying for service at an existing location served by Citizens' Electric, please scroll down to the signatures area.

• Your account will be charged 6% Sales & Use tax unless a PA Exemption Certificate is received. If all or a portion of your company is tax exempt, please fill out a PA exemption form (available at https://smartpay.gsa.gov/sites/default/files/wysiwyg/PA%20REV-1220AS.pdf) and return it to Citizens' Electric. Your account will be charged 6% until this form is received. The completed form can be emailed to billing@citizenselectric.com, faxed to 570-524-5887, or sent via US Mail to 1775 Industrial Blvd, Lewisburg PA, 17837.

New construction information
Please provide as much information as possible.

What type of service are you requesting?

Permanent Service
Temporary Service
Overhead
Underground
Single-Phase
Thee-Phase

(Check all that apply)

Service Size (Amps)

Service Voltage Required

Construction Status

Electrician's Name

First Last

Electrician's Address

Street Address City

Electrician's Phone

Builder's Name

First Last

Builder's Address

Street Address City

Builder's Phone

Nearest pole or pad #

Approximate distance to pole or pad (feet)

Total Square Feet Under Roof

Please provide the single and/or three phase loads for the following:

Cooking (kW)

Space Heating (kW)

Refrigeration (kW)

Elevators (hp)

Water Heating (kW)

Lighting (kW)

Motors (Total hp)

Horsepower and voltage of largest motor

Pool (kW)

Air Conditioning (kW)

Process Heating (kW)

Computers (kW)

Other (list) (kW)

Estimated peak demand in kW for Summer

Estimated peak load in kW for Winter

Please describe any unusual loads

Estimated power factor

Thank you for your information.

Signature(s)

Primary Digital Signature - Please type your full name*

Title

Date

Secondary Digital Signature (if applicable) - Please type your full name

Title

Date

Comment

Consent*

I/We agree to the application terms.

The applicant agrees to abide by the established rules and regulations of Citizens’ Electric Company of Lewisburg, PA, now in force, or which may hereafter be enacted or adopted for the governance and regulation of said Company, and to pay for service at the adopted rates as filed with the Pennsylvania Public Utility Commission or any subsequent rates which may be filed and accepted by the Pennsylvania Public Utility Commission. Rules, regulations and rate schedules are on file and may be inspected at the Company office.

Failure to notify the Company of your intent to terminate service and/or pay your account in full upon such termination will result in the Company using those legal remedies available to secure full payment and all associated costs.