I am moving into an existing service:

Yes No

I am moving out of an existing service:

Yes No

I am an:

Owner Renter

Name:

Email address:

Contact phone number:

Physical Address of Service:

New Mailing Address:

Northern Lights account number:

Northern Lights meter number:

Date transfer will be effective:

Note: A deposit may be required for new members. Deposits may be waived by providing a letter of credit from your previous utility company or by signing up for our auto pay program.