New Holstein Utilities

	Change Mailing Address
	Transferring Service
	Terminating Service
	New Residential Service
	Bill Payment Options
	Report Street Light Outage
	Voluntary Contributions
	Web Site Survey
	Quick Feedback

Welcome to New Holstein. We’re happy to be your new utility provider. Please complete and submit the online form below to establish service at your new residence. We are available for connects and disconnects Monday through Friday. We do require a 24 hour notice.

INFORMATION FOR NEW LOCATION

*Date of new service
New Address
*Name(s) on account
Social Security Number
Driver's License number
Driver's License state
*Street address
Apartment number
*City
*State
*Zip
*Rent or Own	Rent Own
Landlord name
Landlord phone number
*Daytime phone number
*Evening phone number
Mobile phone number
Email
Emergency Contact phone number

Previous Address
*Street address
*City
*State
*Zip
*Rent or Own	Rent Own
Landlord name
Landlord phone number

Employer
Employer name
Daytime phone number

Spouse or Roommate Information
Name
Social Security Number
Employer name
Daytime phone number
Second Roomate
Name
Social Security Number
Employer name
Daytime phone number

Any other specific instructions:
For our meter reader's safety, if you own a dog, what breed is your canine?
Dog's name
Are there any other animals in your home? Please list:
*What is 2 x 2? (This reduces spam.)

*Required fields: this information is required to open a new account for electric service. The utility may need to contact you to verify any or all of the information.