Transfer Electric Service to a New Address

*Don’t forget to update your autopay on our website or call our office for assistance at 515-733-4691*

Name*
First Last
Date of Birth*
Driver's License #*
Drivers License State*
International ID Country*
Phone*
Email*
I wish to have my bills emailed to me*
- Yes
- No
I am interested in Automatic Payments*
- Yes
- No
Current Address*
Stop Date*
MM slash DD slash YYYY
New Address*
Start Date*
MM slash DD slash YYYY
Mail Address*
Same Address?
- My mailing address is the same as my service address
Spouse / Roommate Information
Spouse / Roomate?
- I don’t have a spouse or roommate
Spouse / Roommate Information 1
First & Last Name Phone Email Birthdate
Spouse / Roommate Information 2
Driver's License Number Driver's License State Employer Employer Phone
I hereby apply to the Story City Municipal Electric Utility for utility service to be delivered at the service address listed above beginning on the selected date, in accordance with the Utility’s rules. I agree to pay all bills rendered for utility consumption until I notify the Utility Office to discontinue said service. I also understand that a deposit is required upon start of service for rental properties.
Signature of Owner, Officer, or Authorized Agent of Business*
Today's Date*
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