Lowell Community Choice Power Supply Program OPT-OUT or OPT-IN FORM

OPT-OUT or OPT-IN(required)

OPT-IN

OPT-OUT

Account Number(required)

PLEASE ENTER FULL UTILITY (NOT SUPPLIER) ACCOUNT NUMBER: NGRID = 10 DIGITS, EVERSOURCE = 11 DIGITS, UNITIL = 11 DIGITS.

Account Type(required)

Residential

Commercial

Industrial

Streetlights

Name on Account(required)

PLEASE ENTER SERVICE NAME EXACTLY AS IT APPEARS AT THE TOP OF THE BILL.

Street Address (required)

PLEASE ENTER SERVICE ADDRESS (NOT NECESSARILY THE BILLING ADDRESS).

Address Line 2

City(required)

State

Zip Code(required)

Email Address(required)

Phone(required)

Type the characters(required)