Existing Commercial Service Application

Service address

Street Address

Unit/Suite

CityState

Zip Code
Meter number(s)
Business name (as shown on line 1 on your tax return and W-9)
DBA
SIC Code
SIC Codes
Taxpayer ID number
Complete W-9 form and upload it below.
Upload completed W-9 form

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Primary phone number
Format: 000-000-0000.
Secondary phone number
Please enter a valid phone number.Format: (000) 000-0000.
Contact person

First NameLast Name
Title
Billing address (if different than service address)

Street Address

Unit/suite

CityState / Province

Postal / Zip Code
Contact email address
example@example.com
Is your business exempt from sales tax on electricity purchases?
If yes, complete and return ST3 form, indicating percentage exemption.
Upload completed ST3 form

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Do you rent or own the property?
If you own the property, do you want to be set-up as the default landlord?
If you rent the property, provide the name of the landlord/owner

First NameLast Name
Landlord/owner phone number
Please enter a valid phone number.Format: (000) 000-0000.
Start lease/closing date

MonthDayYear
Date
Property needs power restored at the service address
Please indicate date to restore service. NOTE: Connexus needs to be notified at least two business days prior to restoration date. I understand there is a reconnect fee if power needs to be restored. A reconnect fee will be due on the first bill.

MonthDayYear
Date
Signature

Clear
Date

MonthDayYear
Date
Please verify that you are human
By providing your phone number(s), including any mobile number, you authorize Connexus Energy and its agents to contact you regarding your account using any means, including automatic telephone dialing systems, prerecorded voice messages, text messages, or other forms of communication. You understand that message and data rates may apply. Your consent is not a condition of receiving service. If your number changes, you agree to promptly notify Connexus Energy.
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