Remove Electrical Services Request Form

Complete the following form requesting that Welland Hydro disconnect the electrical service and remove all hydro owned equipment at the service address specified below.

Service Address *

Street Address Address Line 2 City Province Postal Code

Welland Hydro Account Number(s):

Add a line for each if multiple accounts exist at service address.

Type of building located at the service address: *

Single Detached House
Semi Detached Homes
Apartment Building
Commercial Building
Industrial Building
Kiosk / Trailer

How many hydro meters are currently installed at this location: *

Requested Removal of Equipment / Services Date *

The actual equipment / service(s) removal date may vary from the requested date based on Welland Hydro's availability.

Contact Information

Provide contact information for the registered owner of the property.

Registered Owner - Full Name *

Is the Registered Owner's mailing address the same as the service address? *

Yes
No

Registered Owner - Address *

Street Address Address Line 2 City Province Postal Code

Registered Owner - Email Address *

Registered Owner - Phone Number *

Is there a Contractor, or alternate contact, for this project? *

Yes
No

Contractor / Alt. Contact - Full Name *

Contractor / Alt. Contact - Address *

Street Address Address Line 2 City Province Postal Code

Contractor / Alt. Contact - Email Address *

Contractor / Alt. Contact - Phone Number *

Would you like to provide us with additional comments regarding this project? *

Yes
No

Comments

Authorization

Authorized By - Full Name *

Title *

Status *

Date *

Confirmation

I confirm that I am the registered owner, or am authorized to act on behalf of the registered owner, and that the information provided is complete and accurate. By submitting this form, I am authorizing Welland Hydro to disconnect the electrical service, and remove all hydro owned equipment, from the service address specified in this form.

*** I am also aware that the registered owner is responsible for ensuring the service has been disconnected prior to demolition. ***

Collection of Personal Information

NOTICE OF COLLECTION: Your personal information is collected on this form by Welland Hydro-Electric System Corp. (“Welland Hydro”) under the authority of the Electricity Act, S.O. 1998, Chapter 15, Schedule A. Welland Hydro will only use personal information for the purpose for which it was collected unless consent is given by the individual to use or disclose it for another purpose. Under certain exceptional circumstances, Welland Hydro may have a legal duty or right to disclose personal information without the individual's knowledge or consent. If you have further questions about this collection, or the ways in which your personal information may be used by Welland Hydro, please contact the Privacy Officer by telephone at 905-732-1381, ext. 233, or by email at privacy@wellandhydro.com.

Submit my Remove Electrical Services Request Form

By selecting the "Submit My Remove Electrical Services Request Form" button below, the request will be sent for processing.

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Customer Request - Remove Electrical Services