REQUEST A NO COST ENERGY SAVINGS REPORT

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

WHAT IS YOUR AVERAGE UTILITY BILL EACH MONTH?*

$100 and under$100-$300$300-$500$500 and up

ARE YOU THE HOME OWNER ON TITLE OF THE HOME?*

YESNO

WHO IS YOUR UTILITY PROVIDER?*

EDISONLADWPSDGEOTHER

HOW DO YOU RECEIVE YOUR MONTHLY UTILITY BILL?*

ONLINEPAPER COPY BY MAIL

UPLOAD A COPY OF MOST RECENT UTILITY BILL

WOULD YOU RATHER WE TEXT YOU OR CALL YOU?*

CALLTEXT

NAME OF REP THAT REFERRED YOU (if applicable)

WHEN IS THE BEST TIME FOR US TO CONTACT YOU?*

MORNING 9:00am-11:00amAFTERNOON 12:00pm-4:00pmEVENING 5:00pm-7:00pmNIGHT 7:00pm-9:00pm

Kinetik Group LLC. DBA Kinetik Energy Written Consent Form MARKETING AUTHORIZATION: By clicking below, I authorize Kinetik to call me directly or through its affiliates and marketing partners, to contact me from time to time by telephone, text, email and/or direct mail with information and offers about products and services that might interest me. I authorize the receipt of such solicitations through the use of automated dialing technology and approve the receipt of pre-recorded messages and text messages at the telephone number I entered above, even if I am on a national or state “Do Not Call” list. Message and data rates may apply. To discontinue or opt out of text messages reply with stop. I understand I am not required to consent to make a purchase. You also agree to our Terms of Service.

PLEASE FILL OUT THE FORM BELOW AND ONE OF OUR EXPERTS WILL GET BACK TO YOU SHORTLY