Service Application Form

Residential Electric Service – Authorization for Credit Check


Fields marked with an asterisk are required.

Note: A credit check cannot be performed without your Social Security Number. Please call the TTD office at 203-866-9271 to supply that information.

  1. Employment Information
  2. If less than 18 months with present employer:
  3. Personal Information
  4. Financial Information
  5. If so, what types of accounts?

By clicking on the submit button, I authorize the Electrical Department to verify the above information, which may include ordering a credit report from a credit reporting agency. I also verify that I have read and understand the Residential Service Policy.