Acquiring a connection Fill in this form. Type of the ConnectionChoose the type of the connection* New connection Broadening an existing connection Temporary connection High voltage connection Personal informationName*Social Security Number*Person 2 nameSocial Security Number of Person 2Billing Address*Postal Code*City/Town*Contact personNamePhone NumberEmail Address* Postal Address for the contract, if not the same as the billing addressAddressPostal codeCity/TownLocation of the connectionTownVillage/areaBlockPropertyRegistration numberAddress of the connectionPostal CodeCity/townMain fuses 3x25A 3x35A 3x50A 3x63A 3x80A 3x100A 3x125A 3x160A 3x200A 3x250A Additional informationDesired time of delivery Day Month Year
