Electrical District #3
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Application for Service

Application for Service

 
Name: Last
Name: First
Middle Initial
If Commercial:  
Business Name
Type of Business
Service Address
Unit (Apt. No. or Suite No.)
City
State
Zip
Social Security
Number:
Driver's License
Number
Telephone Number
 
Mailing Address (If different than
Service Address, please complete)
Unit (Apt. No. or Suite No.)
City
State
Zip
Home Telephone
Number
Cell Number
 
Employer Name
Business Telephone
Employer Address
Unit (Apt. No. or Suite No.)
City
State
Zip
Additional Account
Name
Additional Name
Telephone #
Additional Employer
Additional Employer
Address
Unit (Apt. No. or Suite No.)
City
State
Zip
 
Date Service Requested
Meter Access Information

Please describe any life support equipment that
will be used at this service address!

Turn Off Previous
Address?
Yes      No
Is there a dog at this location? Yes      No
 
Special Instructions
   

Verification Code
Please only type the middle row.

 NOTICE! You must print this form before submitting!!

The following fees are required:

A non-refundable service initiation fee of $25.00 for residential services and a $35.00  for commercial services is required per meter. 

Customer is also responsible to establish credit with the district: 

The nonrefundable account establishment fees AND a security deposit in an amount based on a confidential independent credit score to guarantee 
payment for this service account are due immediately.  If applying online, customers will receive a call back to finalize the application process.
 


If the current electrical service is provided by Electrical District No. 3, a call to 520-424-9021 or 877-811-8700 is necessary to discontinue service at that location.

Customer will be sent a service agreement form, that will need to be signed and sent back to Electrical District No. 3.  (Pink copy is for customer to keep.) 

 

 

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