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

Name*

First Middle Last Suffix

Mailing Address*

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

Phone*

Email*

Service Effective Date*

Applicant is:*

Owner
Builder
Electrician
Tenant
Other

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

Request is for:*

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 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 Phone

3rd Resident Name

First Last

3rd Resident Phone

Additional Residents and Phone Numbers

Nearest relative not living with you:

First Middle Last Suffix

Nearest Relative Address

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

Nearest Relative Phone

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 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)

Residential service will be provided at 120/240 volts, single-phase, three-wire.

Other Service Size

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 State ZIP Code

Builder's Phone

Development Name

Lot #

Nearest pole or pad #

Approximate distance to pole or pad

(feet)

Meter Location

Please indicate preferred meter location as shown on sketch above. Final meter location to be determined by Citizens’ Electric Engineering Department.

Type of Dwelling

Total Square Feet

Heating 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 Features

Thank you for your information.

Signature(s)

Digital Signature - Please type your full name*

Date

2nd resident (if applicable) Digital Signature - Please type your full name

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.

Phone

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