Residential New Service Request
If you are moving into an apartment complex you may not need to submit this form. Please contact your apartment manager before submitting.

Please complete this form to apply for NEW service only.

NOTE: Fields marked * are required. Incomplete applications will not be processed.
The following information will be used to verify identity and for the purpose of a soft credit check.
Service Address
*Service Address:
Apt/Lot (if applicable):
*New City:
*New State:
*New Zip:
Do you own or rent the New Residence?
*Own/Rent: Own Rent
If renting, please provide Landlord information here:
Landlord Name:
Landlord Phone Number:
Landlord Address:
Landlord City:
Landlord State:
Landlord Zip:
Would you like Postpaid (regular) Billing or Prepaid Billing?
With Postpaid Billing you use power up front and pay for it later. Peninsula Light bills members monthly for usage and payment is due upon receipt. Members using Postpaid Billing may be required to pay a deposit based upon credit history. The deposit is returned to members when they leave the area or after 12 consecutive months with on time payments.

Looking to take control of your energy usage and customize your payment schedule? A Prepaid account gives you the flexibility for when and how much you wish to pay - without deposits, late charges, disconnect or reconnect fees.
*Type of Billing:
When should service start?
*Service Start Date:    
If prior to today, your order can only be processed back to the last read date that was billed.
Applicant Profile:
*First Name:
*Last Name:
*Middle Initial:
*Date of Birth:    (MM/DD/YYYY)
*Social Security Number:
Co-applicant Profile:
First Name:
Last Name:
Middle Initial:
Date of Birth:    (MM/DD/YYYY)
Social Security Number:
Where should we mail your bill? (if different from the Service Address)
Mailing Address:
Apt Number:
City:
State:
Zip:
Contact Information:
*Primary Phone Number:
Secondary Phone Number:
Work Phone Number:
*Request Submitted By:    (Full Name)
*Email Address:
Enter the email address again for accuracy.
*Email Address:

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Date (MM/DD/YYYY)





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