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

Community Name(required)

Billerica

Great Barrington

Halifax

Kingston

Lancaster

Plymouth

Williamsburg

PLEASE CHOOSE THE AGGREGATING TOWN OR CITY'S NAME

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

Streetlight

Name on Account(required)

Street Address(required)

Address Line 2

City(required)

State

ZIp Code(required)

Email Address(required)

Phone(required)

Type the characters(required)