New Service - Commercial or Business
This form is to establish service at a Commercial or Business property with an Existing Meter
Account Number
Meter Size
Meter Reading
Business Name
*
Business Name
Tax ID Number
*
Tax ID Number
Email
*
example@example.com
Name
*
First Name
Last Name
Title
*
Title
Driver's License or State Issued ID Number
*
Please include the issuing state
A copy of your Driver's License or State Issued ID is required
*
Browse Files
Drag and drop files here
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of
Primary Phone Number
*
Please enter a valid phone number
Primary Phone Type
*
Please Select
Home
Cell
Work
Secondary Phone Number
Please enter a valid phone number
Secondary Phone Type
Please Select
Home
Cell
Work
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Service Address
*
Service Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you Rent or Own this property?
*
Please Select
Rent
Own
When would you like to Establish Service?
*
-
Month
-
Day
Year
Date
Additional Comments or Information
Additional Comments or Information
Signature
*
By signing you agree to the Terms & Conditions as well as the Rules & Regulations set forth by the Arizona Corporation Commission
Please verify that you are human
*
Amount
Establishment Fee
Guarantee Deposit
Meter Installation Fee
Additional Material/Construction
Sales Tax
Total Due
Payment Date
Method
Submit
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