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Information Request

We'd like to learn more about you. Please complete this form so that we may provide you with specific information.

As a reminder, UGIES only serves commercial and industrial businesses at this time and does not provide energy services to residential homes.

Contact Name:

Title:

Company:

Address:

City, State, Zip:

Phone Number:

Fax Number:

Email:

Best time to call:

If your company has multiple sites, how many?

What type of company is it?

Are you currently using an energy supplier?

Yes

Which utility system(s) currently serve(s) your location(s)?

List applicable utility account number(s):

What is your monthly natural gas usage in:

Apr. thru Oct.?

Nov. thru Mar.?

What is your average monthly electric usage in:

APR. thru OCT.?

NOV. thru MAR.?

Would you like a sales representative to contact you?

Yes

Comments and/or questions.

How did you hear about UGI Energy Services?