If you have any questions about the application or process, please call the Commercial Resource Center (CRC) at 215-235-7077, Monday through Friday 8:00 a.m. to
4:30 p.m. Please e-mail the completed application with the required documents to CRCNewService@pgworks.com or bring the completed application with
supporting documents to a Philadelphia Gas Works (PGW) Customer Service Center.
Application For Commercial Gas Service
Commercial Resource Center
APPLICATION SUBMITTED BY:
DATE:
______________
_____________________________________________ _____________________________________________
PRINT FIRST NAME / LAST NAME SIGNATURE
* Account information would include: customer name, address, account number and natural gas history, customer telephone numbers will not be provided to suppliers.
SERVICE DATE: ____________________________
PROPERTY / SERVICE INFORMATION
*ADDRESS OF PROPERTY
REQUESTING GAS SERVICE _____________________________________________
Current Service Status:
Please check the appropriate box:
# OF METERS REQUESTED?
# OF UNITS IN BUILDING?
BUSINESS TYPE: RESIDENTIAL COMMERCIAL INDUSTRIAL
CORPORATION
DO YOU OWN OR RENT THIS PROPERTY?
OWN RENT
PROPERTY OWNER’S INFORMATION:
NAME: ____________________________________
PHONE: ___________________________________
FIRST NAME LAST NAME
* Required field
BILLING / CONTACT INFORMATION
COMMERCIAL BUSINESSES
MUST COMPLETE THE FOLLOWING:
PA CORP. # EIN #
NAME OF RESPONSIBLE PARTY OR MEMBER
NAME OF CUSTOMER
BILLING NAME: _________________________________________________________
BILL MAILING
_________________________________________________________
ADDRESS:
_________________________________________________________
USE MY EXISTING PGW ACCOUNT NUMBER
Enter ACCT #
*CUSTOMER
E-MAIL:
* Required field
*PHONE: ________________
ON-SITE PROPERTY
CONTACT:
___________________________________
PHONE: _________________
FIRST NAME / LAST NAME OR OFFICIAL BUSINESS NAME
# NUMBER / STREET
CITY STATE ZIP
ACCOUNT HOLDER’S E-MAIL ADDRESS
FIRST NAME / LAST NAME
* Required field
OFFICIAL BUSINESS NAME:
DOWNLOAD and SAVE
this file to your computer before completing
PARTNERSHIP
SOLE PROPRIETORSHIP
Other Please Describe:
LP
GAS IS ON
MyPGW
/MyPGW
@MyTwitter
PhillyGasWorks
pgworks.com
CREATE A NEW PGW ACCOUNT NUMBER
GAS IS OFF
LLC
By signing and submitting this application you are expressly authorizing the Philadelphia Gas Works (PGW), our agents, representatives, affiliates, or anyone calling on
our behalf to contact you with service related, account related, and marketing related information at any telephone number and/or physical/electronic address you
have provided herein. You agree PGW may contact you in any way, including SMS messages (including text messages), calls using prerecorded messages or artificial
voice, and calls and messages delivered using auto telephone dialing system or an automatic texting system. Your cellular or mobile telephone provider may charge
you according to the type of plan you carry. You are also certifying that you understand that your signature is not a condition of purchasing any property, goods or
services and that you may revoke your consent at any time.
PGW Customers: The Public Utility Commission requires PGW to provide licensed natural gas suppliers with customers’ available account* information. The
customer has the right to opt out of having either the natural gas usage information, or both account and gas usage information released to gas suppliers, by
selection on of the following options:
Release my account and gas usage information
Do not release any of my account and gas usage information
Release my account information, but do not release gas usage information
www.pgworks.com
(Customer Care > Gas Choice)
_____________________________________
For more information or update your opt-out status online, visit
PA GAS
BILLING / CONTACT INFORMATION
REQUIRED DOCUMENTATION
LEASE
SETTLEMENT SHEET
DEED
To avoid delays in processing your application please provide one of the following required documents with your application
MAIN HEADQUARTERS/BUSINESS ADDRESS:
CHOICE
* Required fields
Commercial Resources Center Rev. 08/19/2019
