Apply for Residential Service CommentsThis field is for validation purposes and should be left unchanged.Fields marked with * are required.Are you applying for service in our Union County, PA service area?* Yes No Citizens' Electric Company serves customers in Lewisburg, PA and surrounding areas only. This application is for service with Citizens' Electric Company of Lewisburg, PA. Missouri residents should contact Citizens Electric Corporation. Name* First Middle Last Suffix Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanĂ…land IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCĂ´te d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRĂ©unionRomaniaRussian FederationRwandaSaint BarthĂ©lemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTĂĽrkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Primary Phone*Primary Phone Type:*MobileHomeBusinessAlternate PhoneAlternate Phone Type:MobileHomeBusinessEmail* Applicant is:* Owner Builder Electrician Landlord Other Request is for a* New Service at a location not presently supplied by Citizens' Electric Transfer of service at a location already supplied by CItizens' Electric Service Effective Date* If you will be renting, name of landlord, realtor or person to whom you pay rent:*Service Address Same as Mailing Address Service Address is same as Mailing Address above Service Address (Location where service is requested)* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code All adults over the age of 18 on lease, deed, or mortgage must provide information below. All information must be completed or a deposit will be required. There will be more than one person over age 18 living at this location. 2nd Resident First Last 2nd Resident Phone3rd Resident Name First Last 3rd Resident PhoneAdditional Residents and Phone NumbersNearest relative not living with you: First Middle Last Suffix Nearest Relative Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanĂ…land IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCĂ´te d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRĂ©unionRomaniaRussian FederationRwandaSaint BarthĂ©lemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTĂĽrkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Nearest Relative PhoneAs 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 choose the No button below.Release my information to licensed electric generation suppliers: Yes No • To help prevent identity fraud, we will require the Social Security Number 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.New construction information Please provide as much information as possible. What type of service are you requesting? Permanent Service Temporary Service Overhead Underground (Check all that apply)Service Size (Amps)100200320OtherResidential service will be provided at 120/240 volts, single-phase, three-wire.Other Service SizeConstruction StatusIn designLand clearedFoundation inWalls upUnder roofCompleteElectrician's Name First Last Electrician's Address Street Address City Electrician's PhoneBuilder's Name First Last Builder's Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Builder's PhoneDevelopment NameLot #Nearest pole or pad #Approximate distance to pole or pad(feet)Meter Location D E F G H I J K L Please indicate preferred meter location as shown on sketch above. Final meter location to be determined by Citizens’ Electric Engineering Department.Type of DwellingFrame BuiltModularTrailerDoublewideTotal Square FeetHeating Fuel Electric (Geothermal Heat Pump) Electric (Conventional Heat Pump) Electric (Baseboard or Radiant) Oil Natural Gas Propane Wood Other Features Central Air Electric Range Electric Clothes Dryer Electric Water Heater Other Special Energy FeaturesThank you for your information.Signature(s) Digital Signature - Please type your full name*Date 2nd resident (if applicable) Digital Signature - Please type your full nameDate CommentConsent* 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. Δ