Advanced Metering Opt-out Form
Contact Info
Advanced Metering Opt-out Form


CHECK THIS BOX TO VERIFY YOUR REQUEST TO OPT-OUT.
By submitting this form and choosing to opt-out, I understand that I will not have access to the real-time consumption data or to the other features available to other customers that might help me to manage my utility usage and bills.  I understand that the Department of Public Utilities will install a smart electric meter and communication modules to the gas and water meters, but the wireless transmission capabilities will be deactivated. I understand that a meter reader will come to my property to manually read my meter.  I confirm that I am listed as the account holder for the account number and customer ID I provide on this form.  I understand that if I am not the account holder, my electronic opt-out request will be denied, and I will need to contact the Customer Care Center to discuss my request to opt-out.  I understand that I may contact the Customer Care Center at any time in the future should I wish to fully activate my smart meter at no charge.

FIRST NAME

LAST NAME

ACCOUNT NUMBER
This is a 7-digit number on your bill beginning with "3".

CUSTOMER ID NUMBER
This is a 7-digit number on your bill beginning with a "2".

PHYSICAL ADDRESS

ADDRESS #

STREET NAME

APT#

NEIGHBORHOOD

MAILING ADDRESS

If your mailing address is different than your physical address, please enter it here. If it is the same, you do not need to enter anything here.

ADDRESS #

STREET NAME

APT#

CITY

STATE

ZIP

CONTACT INFORMATION

EMAIL 1

EMAIL 2

PRIMARY PHONE #
You must provide at least one phone number to submit this form electronically.  

PHONE # - OTHER 1

PHONE # - OTHER 2



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