1. 1. Electricity
   2. Natural Gas
2. New Service Address:

   1. Street Address:
   2. Apt. Number:
   3. City/Town:
   4. Postal Code:
3. Address You Previously Resided At:

   1. Electricity Account Number:

      When entering your account number please don't include spaces.

   2. Natural Gas Account Number:

      When entering your account number please don't include spaces.

   3. Street Address:
   4. Apt. Number:
   5. City/Town:
   6. Province/State:
   7. Postal/Zip Code:
4. Customer Information:

   1. First Name:
   2. Initial:
   3. Last Name:
   4. Name of Registered Owner:

      Please Note: If Joint Owners or Tenants, please also complete information under
      "Other Adult Permanently Residing at this Address."

   5. Business Name: (If applicable)
   6. Treaty Number: (If applicable)
   7. Band:
   8. Home Phone Number:
   9. Cell Phone Number:
   10. Employer:
   11. Business Phone Number:
   12. How you would like your name
       to appear on your bill:
5. Other Adult Permanently Residing at this Address

   1. First Name:
   2. Initial:
   3. Last Name:
   4. Cell Phone Number:
   5. Treaty Number: (If applicable)
   6. Band:
   7. Employer:
   8. Business Phone Number:
6. Mailing address: (If different from new service address)

   1. Street Address:
   2. Apt. Number:
   3. City/Town:
   4. Province/State:
   5. Postal/Zip Code:
7. Information Provided By:

   1. First Name:
   2. Last Name:
   3. Phone Number:
   4. Email Address:
8. Possession Date
   If purchased, please enter Legal Possession Date:

   1. Day (dd):
   2. Month (mm) :
   3. Year (yyyy):
9. Do you Own or Rent:

   1. Own
      Lawyer: (if own)

      If you own your home, we require the name and telephone number of the lawyer that helped you process the sale of your home

      1. Lawyer Name:
      2. Lawyer Phone Number:
   2. Rent
      Landlord or Building Manager: (If renting)

      1. Name:
      2. Address:
      3. Phone Number:
10. Will this be your principal residence:

    1. Yes
    2. No
11. PAPP: Pre-Authorized Payment Plan

    1. If your current account is on the PAPP,
       do you wish to continue with the same bank information?

       1. Yes
       2. No
       3. I am currently not on the PAPP
    2. If you would like to apply for PAPP or wish to continue PAPP but with different bank information, we require a PAPP application. You can print an application form.
12. EPP: Equal Payment Plan

    1. Enroll in EPP?

       1. Yes
       2. No
    2. If you are enrolling in the EPP between April and August, please note that your EPP will start in September.

Do you have an electricity reading?

1. Yes
2. No

Electricity Meter Reading

How to Read Your Electricity Meter

1. Dial 1*
   
2. Dial 2
   
3. Dial 3
   
4. Dial 4
   
5. Dial 5
   

* Not present on most meters

Electricity
		Meter Number		Dials						Date of Reading
				1	2	3	4	5		dd	mm	yyyy
	1		=
	2		=
	3		=
	4		=
	5		=
	6		=

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Do you have a natural gas meter reading?

1. Yes
2. No

Natural Gas Meter Reading

How to Read Your Natural Gas Meter

1. Dial 1*
   
2. Dial 2
   
3. Dial 3
   
4. Dial 4
   
5. Dial 5
   

* Not present on most meters

Natural Gas
	Meter Number		Dials						Date of Reading
			1	2	3	4	5		dd	mm	yyyy
		=

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Credit Guarantee Policy - Please Read:
If you have not yet established a satisfactory credit history with Manitoba Hydro a credit guarantee may be required. A credit guarantee can be in the form of a Pre-Authorized Payment Plan, credit reference letter, photo identification, irrevocable letter of credit from a financial institution, credit worthy third party co-signer, or a monetary security deposit. Submitting this form confirms you have read and understand this policy statement.

Please Note: If your form has been successfully received you will see a thank you screen after you click the submit button.

Thank You