Residential Sign-up Form

Residential Sign-up Form

Click here for Information about RMLD's GREEN CHOICE option

Electric service is requested for:

Town:

Reading
Lynnfield
North Reading
Wilmington

Own or Rent (requires $50 deposit)

Meter/Service address:

Customer name:

Are you a previous customer of RMLD? Yes No

If yes, previous street address:

Previous town:

Service start date:

This is the date we will use to initiate your account.

Contact person for this account:

SSN or MA driver's license number

Day phone number*:

Home phone number*:

*This is the number we will use to call you today, if we have any questions.

Your e-mail address:

Billing address (if different from service address):

Street:

City:

State:

Zip:

Where can we send your Customer Application for signature?
This needs to be signed, dated, and returned.

Service addressBilling address:

Street:

City:

State:

Zip:

Comments: