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Establish Service Request
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ESTABLISH SERVICE REQUEST
Complete this form to establish new service for a
residential account
. If you are trying to establish service for non-residential purpose then please
contact us
.
If you are transferring service from one location to another, please use the Transfer/Discontinue service feature.
* Required entry
General Information
Your Name* :
Start Date* :
Meter will be read within 3 business days.
Primary Account Holder
Name* :
Prefix :
[Select]
Mr.
Ms.
Mrs.
SSN or DL #* :
(or)
[State]
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
At least one is required
Date of Birth (MM/DD/YYYY)* :
Passcode* :
Decline
Primary Phone* :
(
)
-
Is this a mobile
phone? *
Yes
No
Business Phone :
(
)
-
Email Address* :
Employer :
Secondary Account Holder - Legal Spouse
Required entry when completing this section.
To add a secondary account holder that is NOT a legal spouse, skip this section and
Contact Us.
Name* :
Prefix :
[Select]
Mr.
Ms.
Mrs.
SSN or DL #* :
(or)
[State]
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
At least one is required
Date of Birth (MM/DD/YYYY)* :
Primary Phone* :
(
)
-
Is this a mobile
phone? *
Yes
No
Business Phone :
(
)
-
Employer :
Requested Service Address
Establish Service at this address
Service Address* :
Street Number and Name
Apt/Lot/Unit # :
Unit Description :
E.g. Basement
City* :
State* :
[Select]
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip/Postal Code* :
Mailing Address - If Different than Service Address
Required entry when completing this section.
Address Tips
Mailing Address and Service Address are the same
Mailing Address* :
Street Number and Name
Apt/Lot/Unit # :
Unit Description :
E.g. Basement
City* :
Country* :
USA
Mexico
Canada
USA
Canadian PC
International
State* :
[Select]
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
[Select]
AG
BC
BS
CH
CL
CM
CO
CS
DF
DG
GR
GT
HG
JA
MI
MO
MX
NA
NL
OA
PU
QR
QT
SI
SL
SO
TB
TL
TM
VE
YU
ZA
[Select]
AB
BC
MB
SK
NB
NL
NS
ON
PE
QC
Zip/Postal Code* :
Additional Information
Are you a current NorthWestern Energy customer? * :
Current
Previous
New Customer
Please provide your current address:
Current Address* :
Street Number and Name
Apt/Lot/Unit # :
Unit Description :
E.g. Basement
City* :
Country* :
USA
Mexico
Canada
USA
Canadian PC
International
State* :
[Select]
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
[Select]
AG
BC
BS
CH
CL
CM
CO
CS
DF
DG
GR
GT
HG
JA
MI
MO
MX
NA
NL
OA
PU
QR
QT
SI
SL
SO
TB
TL
TM
VE
YU
ZA
[Select]
AB
BC
MB
SK
NB
NL
NS
ON
PE
QC
Zip/Postal Code* :
Are there any special considerations for the meter reader at this service address? For example, aggressive dog or locked gate. If so, please explain:
By submitting this information, I agree that all the services available at the Requested Service location will be placed in my name.
You must enter the characters below before submitting this request.
Verification Characters :
Enter Verification Characters :
 
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