New Customer Registration Form PUREnergy Inc.

SOLAR Qualification for your home - CA, UT, ID, NV, AZ, WA, MA, RI, CT, NY, NJ, NH, MD, FL, OH, IL, TX, SC, NC

Please fill out entirely and attach all required documents, most fields are required.
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
How did you hear about us?*
How did you hear about us?*
Save TODAY with solar
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Credit Score?*
Roof Condition*
Type of Roof*
Electric bill

Upload a File
Photo of front and back page of your electric bill Cancelof
Electric Utility Service Panel Photo

Upload a File
Photo of all breakers inside main service utility panel, including the main breaker Cancelof
Utility Tariff - Rate Schedule
Ex: TOU, D-Care, D-FERA, etc.
Expected Bill Offset*
Percentage of electric bill to be erased
Financing*
I LOVE owning my power
CALIFORNIA -

So Cal Edison Utility:

1. Call So Cal Edison - 1-800-655-4555 (Ask for last 12 months of usage and payments) OR...

2. Register and Login at sce.com 1.My Account 2. Usage 3. Monthly trend 4. Download as html text

SDG&E Utility:

Register at https://energywave.sdge.com/ and obtain the last 12 months under energy consumption

Riverside Public Utilities:

1. Customer Service Call Center (951) 782-0330 OR...

2. Or login into your online account at www.riversidepublicutilities.com a) Pay my bill b) Login or Register c) Click on Consumption History in left-hand column

RHODE ISLAND -

National Grid:

1. Customer Service Call Center: Electric: 1-800-322-3223

2. Or register an online account at www.nationalgridus.com/RI-Home/Default

UTAH or IDAHO -

Rocky Mountain Power:

1. Customer Service Call Center: 1-888-221-7070

2. Or register an online account at https://www.rockymountainpower.net/wum/cwa1.wcssn.html

Last 12 months usage in kWh Per Month

Rows	Jan	Feb	Mar	Apr	May	Jun
kWh

Last 12 months usage in kWh Per Month

Rows	Jul	Aug	Sep	Oct	Nov	Dec
kWh

Average Monthly kWh*
Alternative of detailed kWh usage above, one or the other is required
Average Monthly Cost
Alternative of detailed kWh usage above, one or the other is required
Additional Information
Enter the message as it's shown*
Should be Empty:

SOLAR Qualification for your home - CA, UT, ID, NV, AZ, WA, MA, RI, CT, NY, NJ, NH, MD, FL, OH, IL, TX, SC, NC