New Residential Account Application

In compliance with the Fair Accurate Credit Transactions Act (FACTA), and the Columbia River People Utility District’s (PUD) Identity Theft Prevention Program, customers are required to provide their valid social security number at the time of this application.

We may access information on your credit report with the Credit Bureaus. Late payments or other defaults on your PUD account may be reflected on your credit report. If you have placed a file freeze on your credit, please temporarily remove the freeze for Experian.

Proof of occupancy and/or a deposit may be required at the time of service. Failure to pay the required deposit may result in immediate disconnection of electric service.

Opening an account constitutes an agreement to be financially responsible for the cost of all utility services provided at this location, at the applicable and established rates, and to be governed by the Columbia River PUD’s General Terms and Conditions. For a complete explanation of your rights and responsibilities, please refer to the Terms and Conditions, which can also be found in our office at 64001 Columbia River Highway, Deer Island, OR 97054.

"*" indicates required fields

URL

This field is for validation purposes and should be left unchanged.

Applicant's Full Legal Name*

Please provide middle initial.

First Middle Last

Start Service Date (MM/DD/YYYY)*

Regular service hours are 8 a.m. to 4:30 p.m., Monday through Thursday, excluding holidays. Requests to start service are typically processed within one business day.

Service Address*

Street Address Unit Number City State ZIP Code

Are you an active member of the US military or an honorably discharged veteran?

Yes

Residence Type*

Own/Buying

Renting

If Renting, Owner's Name & Phone Number*

If Renting, Name(s) on Lease*

Lease/Rental Agreement*

If renting, please upload a copy of your lease agreement.

Accepted file types: pdf, Max. file size: 256 MB.

Deposit Requirements*

Please read our Deposit policy.

I have read the Deposit Requirements.

Mailing Address (if different from Service Address)

Street Address Unit Number City State ZIP Code

Phone*

Email*

I prefer to be contacted by:

Phone

Social Security #*

If you have placed a file freeze on your credit, please temporarily remove the freeze for Experian.

Date of Birth (MM/DD/YYYY)*

Co-Applicant's Full Legal Name

Please provide middle initial.

First Middle Last

Co-Applicant's Phone Number

Required if applicable

Co-Applicant's Email

Required if applicable

Co-Applicant's Mailing Address

Required if applicable

Street Address Unit Number City State ZIP Code

Co-Applicant's Social Security #

Required if applicable

Co-Applicant's Date of Birth (MM/DD/YYYY)

Required if applicable

Authorization I am requesting utility service at the above indicated location. By completing this form, I agree to be financially responsible for the cost of all utility services provided at this location until I close the account. Only those persons listed on the account can receive account details. To authorize others access to your account information, please call our office at (503) 397-0590. Failure to receive mail or an electronic bill does not release you from payment obligations. A Security Deposit may be required. In its sole discretion, the PUD may require at any time a Deposit as a guarantee of performance by the customer (delinquent account, high usage, etc.). The PUD may disconnect Electric Service for failing to pay for services rendered, tampering with PUD meters, connections or other equipment, diverting service, committing fraud, or theft of Electric Service. Refer to the General Terms and Conditions for complete explanation.

Applicant Signature*

By typing my name below, I am acknowledging that I have consented to receive automated phone calls and/or text messages, that I understand this application for service, and that I affirm the above information is correct to the best of my knowledge:

Additional Information

New Residential Account Application

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