Customer Information (to be completed by customer)
Name of Customer
Type of Business
Official in Charge Name
Title of Official
Person Controlling Meter Access
Meter Access Phone
Mailing Address (if different from Service Address)
The Company requires the submission of the following documents to substantiate the information provided in the service application.
deed lease other
TO BE FILLED OUT BY RELIGIOUS ORGANIZATIONS, COMMUNITY RESIDENCES, AND VETERAN'S ORGANIZATIONS:
The Public Service Law, Section 76, permits certain corporations or associations organized and conducted in good faith for religious purposes, including the operation by such corporation or association of a school, notwithstanding that secular subjects are taught at such school, certain community residences as defined in the Mental Hygiene Law, and posts or halls owned or leased by a not-for-profit corporation that is a veterans' organization, to receive services at rates no greater than the rates charged to residential customers. Residential rates are lower than commercial rates for most
customers but not for every customer. If Enbridge St Lawrence Gas denies the customer residential rates, the company shall upon written request inspect the applicant's premises and review the company's decision in light of the information obtained form such an inspection. The applicant may appeal Enbridge St. Lawrence Gas' denial of residential rates to the Public Service Commission.
Applicant/Applicant's representative acknowledges this section has been read. yes
Applicant is applying for Residential Rates.
If you have any questions about your classification, you may discuss this with your customer service representative. If your use of service or your equipment changes in the future, you must notify the utility of these changes to assure that your are being properly billed.
About Your Business
WARNING: If the information provided by you in this section is inaccurate or incomplete, you may be subject to backbilling on the correct service classification, or you may be precluded from receiving a refund for overcharges based on the correct service classification.
Which of the following best describes your business or premises? (Check only one)
mobile home park
rooming or boarding house
Does this Account provide Service for any type of Residential Unit? yes no
If yes, please explain
Date You Are Responsible
Is this account Sales Tax Exempt? yes no
If yes, exempt certificate must be provided to Company. Until copy of certificate is supplied to Company, sales tax will apply.
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