Start Service


form steps

Please complete this form if you are not an OPPD customer and would like to start service. For questions, contact Customer Service.

Business Information

Business Name  
Ownership Type



Service Phone Number () -
EIN (Tax ID Number) -
Year Business Started
Other Business Names
 

Contact Information

 (the person OPPD may contact about this service request)
Name     
E-mail Address   
Daytime Phone () -
 

Business Officer Information

 (a principal officer associated with the account)
Title

Name
Social Security Number - -
Phone Number () -
 

New Service Address

 (Moving To)
Service Address          Unit/Suite Number
City      State     Zip 
 
Do/will you purchase or lease/rent the property?
Would you like to attach an additional business officer to the account?

Start Service Date

 
  Terms and Conditions. (You must agree to the terms of service to continue.)

Mailing Address

 
Address Unit/Suite Number
City    State Zip