Get A Natural Gas and Electric Quote Get a Natural Gas and/or Electric Quote Today! Why Us? Company History FAQ Contact Us Please Note: At this time we are not accepting residential customers Contact Information Fields marked with * are required Contact Person* Company Name* Email Address* Phone Number* Fax Number Current Utility* How Many Accounts 1234 or more Please enter any additional accounts in the comments box at the end of this form. Account Information Account Number* (POD ID for NYSEG Customers) Account Type* —Please choose an option—ElectricNatural GasBoth Service Address* Account #2 Information Account Number (POD ID for NYSEG Customers) Account Type —Please choose an option—ElectricNatural GasBoth Service Address Account #3 Information Account Number (POD ID for NYSEG Customers) Account Type —Please choose an option—ElectricNatural GasBoth Service Address Comments or Additional Accounts How Did You Hear About Us?* —Please choose an option—Utility WebsiteMailerInternet SearchOther Business OrganizationFriends and FamilyOther Other: Authorization Empire Natural Gas will require your previous 12 months consumption and cost history from your local utility. This authorization in no way binds you to the purchase of any service or product from Empire Natural Gas Corporation and is to be used for the sole purpose of determining the price of electricity/gas services. You can authorize your utility to provide us with the information by filling out the following form OR downloading our Customer Authorization form for release of consumption and pricing information. By typing your initials in the box below, you are allowing Empire Natural Gas to view your previous 12 month consumption and cost records. Initials: *
