If you believe your electric bill is higher than expected and you are unsure why, please complete the form below. To properly investigate your concern, we require accurate and honest information. The details you provide are essential for us to perform a thorough electric usage review. Incomplete or inaccurate information may prevent us from identifying the cause of high usage. Please provide any additional details on appliances & equipment for a more accurate assessment (Model #, Wattage, etc.). Once we receive your completed form, we will conduct a detailed analysis of your electric usage and email the results back to you. Member Information First Name Last Name Account Number Service Address Address City/Town ZIP/Postal Code Email Address Phone Number Best Time to Contact Home Information Year home built: Year home built:: Year Square footage of home: Number of floors: - Select -123 Adults in the home: - Select -12345678 Children in the home: - Select -012345678 Is anyone home during the day? - Select -YesNo Heating & Cooling Primary heating source (check one) Propane Natural Gas Fuel oil Wood/pellet Do you have a blower on your wood or pellet heating system? - None -YesNo Electric Mini split Heat pump Other Please explain: Air conditioning (check all that apply) Central AC Mini split Number of mini splits: Window units Number of window units: Fans only Number of fans only: None of the above Do you have ANY electric heat sources (check all that apply)? Baseboard heaters Number of baseboard heaters: Space heaters Number of space heaters: Garage heater Number of garage heaters: Basement heater Number of basement heaters: Crawlspace heater Number of crawlspace heaters: Heat tape/pipe heaters Number of heat tape/pipe heaters: None of the above Water Heating Water heater type (select one) Electric tank Electric tankless Propane Oil Heat pump water heater Size of water heater: - Select -30 gal40 gal50 gal75 gal85 gal100 gal105 gal Approximate age of water heater: - Select -0-5 years old5-10 years old10-15 years old15-20 years oldOver 20 years Do you have a hot water recirculation pump? - Select -YesNoNot Sure Well & Water System Water source Private well Well pump horsepower (if known): - None -1/3 HP1/2 HP3/4 HP1 HP1.5 HP2 HP3 HP5 HPNot sure Approximate age of pressure tank: - None -0-5 years old5-10 years old10-15 years old15-20 years oldOver 20 years Have you noticed pump running frequently? - None -YesNoNot sure Municipal water Water softner Yes If YES, Regeneration frequency: - Select -Daily2-3x per weekWeekly No Major Appliances Do you have any of the following (check all that apply)? Electric clothes dryer # of units Electric oven/range # of units Induction cooktop # of units Chest freezer # of units Refrigerator # of units Dehumidifier # of units Electric fireplace # of units Electric blanket # of units Electric mattress pad # of units None of the above Outdoor/Hidden Loads Do you have any of the following (check all that apply)? Hot tub/spa Pool pump Pool heater Livestock water heater Stock tank heater Heated driveway/walkway Heat tape on pipes Detached garage heater Workshop heater Shed/barn electric service Large Air Compressor Size of air compressor: - None -1-6 gallons6-20 gallons20-30 gallons60-80+ gallons Roof/Gutter De-Icer EV Charger None of the above Electronics/Equipment Do you have any of the following (check all that apply)? Gaming PCs # of Units Cryptocurrency mining equipment # of Units Server equipment # of Units Grow lights # of Units Large aquarium heaters # of Units Radon mitigation fan # of Units None of the above Recent Changes In the past 2 years have you: Installed new appliances Please explain: Installed heat tape Please explain: Added freezer/refrigerator Please explain: Added workshop equipment Please explain: Installed electric vehicle charger Please explain: Installed livestock water heater Please explain: Installed hot tub Please explain: No changes made Diagnostic Questions Do you hear the well pump running often? Yes No Does the water heater run frequently? Yes No Not sure Do you have anything plugged in that runs 24/7? Yes No If Yes, please explain: Electrical Panel Information Panel size: 100 amp 150 amp 200 amp Do you have subpanels? Yes No
