Type of Service
(Required)
Electric
Gas
Water
Account Type
(Required)
Residential
Commercial
Residential and commercial
Utility Company Name
Competitive Supplier Name
Account Number
Name
(Required)
First
Last
Address #1
(Required)
Address #2
City
(Required)
State
(Required)
Zip Code
(Required)
Phone Number
(Required)
Additional Phone Number
Email
How should we make contact with you regarding your complaint?
Please call me.
Please send me an email.
Preferred spoken language
Here is my complaint:
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