Utility Shut-Off Survey
If one or more of your utilities has been disconnected since March 16 please take the survey below. We are in this together and we must speak out against utility disconnection during this worldwide crisis. All of the questions need to be completed for us to verify and accurately report shut-offs. Any information provided, including your name is strictly confidential. A member of our staff may contact you for more information.Thanks for sharing your story and helping us stop wrongful disconnections.
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First and Last Name *
Email Address *
Telephone Number *
 Service Address (this is necessary to confirm utility provider) *
City *
Zip-code *
Type of Service *
Utility Company Name *
How much was your balance? *
What date was your utility disconnected? *
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When was your last payment made? *
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Are you on a Pre-Pay plan? *
Please use the space below to share how this has affected your family and any other information you want us to know.
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