LOA – Atlantic Energy Alternatives

Letter of Authorization

The undersigned hereby authorizes Atlantic Energy Alternatives to request historical energy usage and billing information from the relevant utility. The undersigned represents that they have the authority to release the information described below on behalf of the company and provide their account numbers for the sole purpose of energy procurement.

Please return this authorization with a copy of a current energy bill.

Company Information
Company Name*
Name*
First Last
Title*
Email*
Phone*
Service Address*
Street Address Address Line 2 City State ZIP Code
Billing Address - If different from Service Address
Street Address Address Line 2 City State ZIP Code
Utility Information
Electric Utility Supplier
Electricity Account Number
Gas Utility Supplier
Gas Account Number
Utility File Upload
Please upload recent Utility Bills Here.
Drop files here or
Authorization and Signature
I understand that my typed Name in the section below constitutes a legal signature confirming that I authorize Atlantic Energy Alternatives to request historical energy usage and billing information from the relevant utility provider(s) for the company listed. I also confirm that I have the authority to release the information described on behalf of the company and provide their account numbers for the sole purpose of energy procurement.
Signature*
First Last
Date*
Date Format: MM slash DD slash YYYY

Company Information

Utility Information

Authorization and Signature