COMMERCIAL / INDUSTRIAL SERVICE INFORMATION FORM

Before Fayetteville PWC can proceed with your design, application for new construction service is required.

Please provide the necessary billing and design information on this form and contact PWC's Builders Group to apply for service.

For any questions, please contact BuildersGroup@faypwc.com

1Customer Information > 2Contractor Information > 3Load Sizing Information > 4Structure Information
New or Existing Customer?

New or Existing Customer? New Existing
Please provide the PWC account number:
Service address where work is being performed: Service address where work is being performed:
Street Address City Postal / Zip Code
Type of business to be served:
Property Owner Contact Info (the owner listed on the Account)
Property Owner Name (Company Name or Customer Name) Property Owner Name (Company Name or Customer Name) First Last
Property Owner Address Property Owner Address
Street Address City State / Province / Region Postal / Zip Code
Property Owner Phone Property Owner Phone - ### - ### ####
Property Owner Email
Customer Who Will Receive Invoice for Construction Charges
Check "Yes" if this is the same as the property owner

Check "Yes" if this is the same as the property owner Yes No
Customer's Name (Company Name or Customer Name) Customer's Name (Company Name or Customer Name) First Last
Customer's Address Customer's Address
Street Address City State / Province / Region Postal / Zip Code
Customer's Phone Customer's Phone - ### - ### ####
Customer's Email
Customer Who Will Receive the Monthly Bill for Electric Service
Check "Yes" if this is the same as the property owner

Check "Yes" if this is the same as the property owner Yes No
Customer's Name (Company Name or Customer Name) Customer's Name (Company Name or Customer Name) First Last
Federal Tax ID
Customer's Address Customer's Address
Street Address City State / Province / Region Postal / Zip Code
Customer's Phone Customer's Phone - ### - ### ####
Customer's Email
Previous Service Address Previous Service Address
Street Address City State / Province / Region Postal / Zip Code

COMMERCIAL / INDUSTRIAL SERVICE INFORMATION FORM

COMMERCIAL / INDUSTRIAL SERVICE INFORMATION FORM

Property Owner Contact Info (the owner listed on the Account)

Customer Who Will Receive Invoice for Construction Charges

Customer Who Will Receive the Monthly Bill for Electric Service