ANGLEC Email Billing Registration Form

Phase 2 of the ANGLEC Paperless Project

Please use this form to add your email address to the programming waiting list for the rollout of mass email billing coming soon to ANGLEC!

Thank you!

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* 1. What is your name?

First Name

Middle Initial

Last Name

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* 2. Are you the noted ANGLEC account holder on file?

Yes

No

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* 3. Please note the account you're requesting billing for:

Name of Account Holder (s)

Account Number

Meter Number

Location

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* 4. If you are not the account holder, please list your full name and contact details below:

First Name

Last Name

Phone number

Email Address

Relationship to Account Holder

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* 5. Please list the email address(s) where bills for the listed account should be sent:

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* 6. CONFIRMATION & VERIFICATION: I hereby confirm that all information and authorization provided in this electronic form is true and within my right to submit.

I also agree to be contacted by an ANGLEC representative for further information or verification if needed.

Kindly note, those who deny this section forfeit the right to have updates to the account or be contacted for further verification and no changes will be made to the account.

Yes, I confirm.

No, I deny.

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* 7. Additional Questions, Comments or Concerns: