Letter of Authorization - Customer Information Request

Letter of Authorization - Customer Information Request

Please complete this form to allow us to communicate with your utility on your behalf, you can modify what we have access to in the checklist below. please note if you do not provide access to interval data or bills you will be responsible for sending these files directly to us when required.
Full Name
Contact Number
Job Title
Email Address
{fullName} hereby authorizes and directs their local utility company to release the Client’s detailed historical usage and billing information to Edgecom Energy for the Utility Account(s) and addresses referenced below. Client information will be held in confidence by Edgecom Energy to the standard that Edgecom Energy deals with its own confidential information.
Information to be released:

Interval data pertaining to the Facility Addresses identified below, collected on an ongoing basis as of the date signed.All billing data pertaining to the facility and dates mentioned above.Client agrees to provide guest users or delegate access to the LDC online billing and interval data portals if requiredAll requested information that pertains to the distribution and transmission power infrastructure systems that serve the addresses listed belowPermission to apply for KYZ pulse output access from the LDC meter.
Facility Information*
Signature
Date

MonthDayYear
Date
Should be Empty: