Yes! I'd like to take advantage of Summary Billing for my business. After we receive your completed form we will call or send you an e-mail within a couple of days to set up your Summary Billing account.
Items in red are required.*
Contact Person for AccountLast Name*
State*AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Business Phone* - -
I'd also like to learn more about how I can enroll my new Summary Billing account in Online Billing.
Account numbers to include in my Summary Billing Account: