Regulated Price Plan Election Form

Mandatory fields are indicated with a red asterisk (*).

Please complete and submit this form if you want to change the Regulated Price Plan (RPP) structure that applies to the Electricity line on your bill. There are two options: Time-of-Use and Tiered.

Under Time-of-Use pricing, the price you pay for electricity depends on when you use it.
Under Tiered pricing, you can use a certain amount of electricity each month at a lower price, and once that limit is exceeded, a higher price applies.

For more information on Time-of-Use and Tiered Pricing and tools to help you decide which price structure is right for you, please visit www.oeb.ca/choice

If you have any questions about this form, please contact Energy+ Customer Care, Monday-Friday from 8:30 a.m. to 4:30 p.m.

Telephone: 519-621-3530 or 1-877-871-2215 Email: customercare@energyplus.ca

Notice of Collection

Personal information is collected on this form by Energy+ Inc. under the authority of the Electricity Act, S.O. 1998, Chapter 15, Schedule A. The principal purpose for the information we are collecting is to accurately deliver our services to you, billing and collection, and ensuring that we are dealing with only you or individuals you have authorized. Personal information will be used only for the purposes set out in Energy+’s Privacy Policy. Learn more www.energyplus.ca/privacy

If you have any questions about this collection, the ways in which your personal information may be used by Energy+, or would like further information about Energy+’s privacy policies, please contact: Energy+’s Chief Privacy Officer, 1500 Bishop Street, Cambridge, ON by phone 519-621-3530, or by e-mail at: privacy@energyplus.ca.

Account Holder Information

Before you begin, make sure that you have a copy of your Energy+ electricity bill for reference.

Utility Account Information: Please enter your information exactly as it appears on your Energy+ bill.

Account Holder Full Name(s):

Account Number

Service Address:

City:

Province:

Postal Code:

Home Phone

Work Phone

Cell Phone

Email Address

Choose A Price Plan Structure

Please choose your desired price plan structure:

I am currently billed on Time-of-Use and I would like to be switched to Tiered.

I am currently billed on Tiered and I would like to be switched to Time-of-Use.

How Can We Contact You?

Please select a preferred way we should contact and/or communicate with you about your price plan choice::

Telephone

Mail to Service Address

If you would like us to Mail to an address other than the Service Address, please provide the Alternate Address here:

Authorization and Declaration

By signing below,

I declare that the information I have provided in this application is true and correct; and
I indicate my consent to the collection, use and disclosure of my personal information as described in this form.

Date:

Account Holder's Full Name(s):

Signature of Account Holder: