New Electric Account Sign Up

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Customer Enrollment INFO REQUEST

Please complete form fully

Mobile Phone *

City *

Zip *

Comments

Email *

What Services do you need? *

Electricity

Internet/TV

Security System

Renter's Insurance

Agent has obtained permission from consumer to disclose their nonpublic personal information to Abshire & Associates, Inc. - OurEnergyGuy.com. This release includes their phone numbers, new address, social security number and date of birth. The sole purpose for this release is to establish utility services for this prospective client. *It is required that all requests for service be verified by an independent third party.

Third Party Verification 866-942-6248.

New service start date *

Length of Lease *

Language

English

Spanish

Questions or need assistance? Call us!
469-300-5100 office

*It is required that all requests for service be verified by an independent third party.

Leasing Agent's Name *

State *

First & Last Name *

Address *

Work Phone

Apartment/Unit *

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