Request for Service - Halton Hills Hydro

Account Information

Name of Business *

Service Start Date *

Move In Dates scheduled for weekends or holidays will be read on the first available business day after.

Existing Halton Hills Hydro Account Number (If Applicable)

Service Address *

Street Address Address Line 2 City Province Postal Code

Mailing Address (If different from service address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Applicant Information

Applicant *

Applicant Position *

Applicant Phone No. *

Applicant Email *

Business Information

Type of Business

Doing Business As Name

NAICS

Please refer to: North American Industry Classification System (NAICS) Canada 2017

Type of Ownership

Proprietorship
Partnership
Limited
Subsidiary

Legal Name of Parent Company

Property Information

Does the business Own or Rent the property?

Own
Lease

Property Owners Name

Property Owners Phone No.

Property Owners Address

Pricing Plan

Pricing Plan Options: *

Residential customers have the option of choosing between Time-of-Use and Tiered pricing for the electricity they use. Under Time-of-Use pricing, the price you pay for electricity depends on when you use it. Under Tiered pricing, you can use a certain amount of electricity each month at a lower price, and once that limit is exceeded, a higher price applies. For more information on Time-of-Use and Tiered Pricing and tools to help you decide which price structure is right for you, please visit https://haltonhillshydro.com/for-home/electricity-pricing/. To view the current electricity prices visit the Ontario Energy Board’s website at www.oeb.ca/choice

Note: you can change your pricing option at any time.

(A) I wish to be billed Time-of-Use Pricing
(B) I wish to be billed Tiered Pricing

Payment Plan

Payment Plan Option *

NOTE: For Option A, complete the banking information below or attach a void cheque along with this application form. Pre-Authorized payments are deducted from your bank account upon due date of your bill.

(A) I/We wish to enroll in the Pre-Authorized Payment Plan.
(B) Do not include on payment plan.

Banking Information

Bank Holders Name *

Please, choose an option for send your bank account informaton *

Enter Banking Details Below
Attach a Cheque

Name of Bank *

Where can I find my banking information?

Bank Transit *

Bank transit must contain 5 characters

Bank Number *

Bank number must contain 3 characters

Account Number *

Attach a Cheque *

Max. file size: 8 MB.

E-Bills

Receive your hydro bill via email, and review your billing history online. Register now and your next hydro bill will be sent to the email address listed below.

Enroll in E-Billing

Enroll
Opt-Out

Email *

Enter Email Confirm Email

Security Arrangements

Halton Hills Hydro requires the payment of a security deposit from all customers who have not demonstrated a good payment history. Your security deposit will be on your first bill. To be exempt from this deposit, we require the following to be attached to this application or faxed to (519) 853-2621.

NOTE: Reference must be provided in the same name as the applicant listed on this application. Three to Seven (3 - 7) years of good payment history is required, some of which must have occurred in the past twenty-four (24) months.

Reference

Good payment history from a previous account with Halton Hills Hydro
Reference Letter from another electricity or natural gas utility in Canada. (Please fax reference letter to (519) 853-2621.) Note: The Business Name must match the current Business Name.
Equifax Credit Report showing good payment history. Equifax: 1-800-465-7166 OR www.equifax.com (Please include report with this application.)

Previous Account Number

Previous Service Address

Street Address Address Line 2 City Province Postal Code

Equifax Credit Report

Accepted file types: pdf, doc, docx, Max. file size: 8 MB.

Acknowledgement

I/We agree to accept Distribution Services from Halton Hills Hydro in accordance with their Condition of Service and be bound by them as they exist and are subject to change. Halton Hills Hydro’s Conditions of Service may be viewed on our website at www.haltonhillshydro.com. If you are a tenant, the owner’s name and address will be used to provide notice in the event your service is disconnected. The owner may also be notified of your final billing date. Customers listed above and have signed below accept financial responsibility for the account and can access all account information. Also, by signing the below noted you are accepting the Residential and Commercial Contract Terms.

Halton Hills Hydro is the billing agent for Halton Region water services. I/WE agree to accept water services from Halton Region (if applicable). Halton Region’s unpaid water arrears may result in water service interruption pursuant to Part XII of the Municipal Act, 2001 and Halton Region’s Waterworks By-Law, fees and charges are deemed to constitute a debt of the consumer to the municipality. The Act enables this debt to be added to the Tax Roll and collected in the same manner as municipal taxes. If you are a tenant with outstanding water arrears the property owner may be notified.

Accept Terms *

I Accept

Account Information

Applicant Information

Business Information

Property Information

Pricing Plan

Payment Plan

Banking Information

Where can I find my banking information?

E-Bills

Security Arrangements

Acknowledgement

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