Apply for Residential Service

Please fill out this form online to request a change of address or to open and account with us.

Apply for Residential Service

Please fill out this form online to request a change of address or to open and account with us.

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1
Application for Residential Service
Customer Information
Service (effective date)
First Name
Last Name
Initial
Street No.
Street Name
Unit
City
Province
Postal Code
Date of Birth
Home Phone
Work Phone
Cell
Name of Spouse (to be listed on account)your full name
Mailing Address (if different from above)
Street No.
Street Name
Unit
City
Province
Postal Code
Property Information
Are you the property owner?
Are you the tenant?(if yes, enter property owner info below)
Owner (full name)
Phone
Credit Information
Name of Employer
Address
If unemployedplease check
Name of Worker
Phone
Identification
(2 pieces required (1 photo ID)
Ontario Photo Card
Driver's License
Other(please specify)
Previous Address
Street No.
Street Name
Unit
City
Previous Hydro Utility
Name of Bank
Branch Location
* A security deposit is required unless customer is enrolled in the Pre-Authorized Payment Plan (PAP). Credit reference from a previous utility is required for PAP.
Deposit Amount $
OR
I have read and understood the statement (see reverse) of Lakeland Power regarding the contractual obligations, collection, use and disclosure of my personal information, and I hereby consent to have Lakeland Power collect and use my personal information for the purposes as stated.
Applicant Signature
Date
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Or you can download the form below and return it to us by mail, fax, drop off at our offices, or send it by mail to:

200-395 Centre St North, Huntsville, ON P1H 2M2 | Fax (705) 789-3110
Tel (705) 789-5442 or 1-888-282-7711 | Email: service@lakelandpower.on.ca