Reconnection Form

I am living at the below noted property and understand an account is required for set up according to the Conditions of Service with Milton Hydro. I will contact the office on the next business day to set up my account. A $30.00 + HST set up fee is applicable on all new accounts.

I authorize Milton Hydro Distribution to reconnect my hydro service afterhours at a cost of $185.00 + (24.05) HST = $209.05. This amount will be invoiced to me on my next hydro bill.

First Name:
Last Name:
Phone Number:
Email:
Service Address:
Unit Number:
City/Province:
Postal Code:
Owner/Tenant:	Owner Tenant
Security code:	Enter security code: By submitting this form you are accepting the terms above.