Forms

Letter of Authorization for the Request of Historical Usage Information Form (English)

Reference: Section 7.5.1, Overview of the Letter of Authorization for Historical Usage

Date(Required)

Expiration Date

Select Transmission and/or Distribution Service Provider (TDSP) (Required: Select the TDSP the request applies to.)(Required)

Oncor

CenterPoint Energy

Nueces

AEP

TNMP

LP&L

Please accept this letter as a formal request and authorization for the above referenced TDSP to release energy usage data, including kWh, kVA or kW, and interval data (if applicable) at the following location(s) to Satori Energy by way of The Electric Cowgirl. This information request shall be limited to no more than the most recent 12-month period of service. If the Electric Service Identifiers (ESI ID(s)) are metered using an Interval Data Recorder (IDR), please indicate whether summary level and/or interval data is required.

summary level and/or interval data is required

Summary Billing Data Only

Interval Data Only

Both Summary and Interval Data

Please forward usage and Load information in electronic (Microsoft Excel) format using Retail Market Guide Section 9, Appendices, Appendix B4, Transmission and/or Distribution Service Provider Response to Request for Historical Usage, to: E-mail: holly@electric-cowgirl.com

If an attachment is used, please use a separate attachment per TDSP with the ESI IDs that are specific to a TDSP. The TDSP will reject submitted ESI IDs that are not located within the TDSP’s territory.

Attachment

Max. file size: 512 MB.

Service Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

ESI ID Number (found on bill)(Required)

AUTHORIZATION

I affirm that I have the authority to make and sign this request on behalf of my company for all ESI IDs that are associated with this request.

Signature(Required)

Name(Required)

First Last

Company(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Letter of Representation

Authorization Agreement

The undersigned certifies that they have the authority to authorize the release of the information described below. The undersigned is working with The Electric Cowgirl and hereby authorizes Satori Energy to request historical energy usage and billing information from the relevant electric and/or natural gas utility so that energy usage patterns may be evaluated and exclusively obtain offers for electric and/or natural gas service for our company. Satori Energy does not have the authority to sign any other form(s) or contracts on our behalf. This authorization does not require the undersigned to enter into an electricity or gas contract, it merely provides the ability to provide quotes for the Client.

Signature

Account Name (as it appears on energy bill)

First Last

Authorized Signature

Date

Phone

Fax

Electric/Gas Utility

Account Information

Please include copies of all pages of a recent bill for each account.

Service Account Number

Service Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Legal Entity Information

Contract Information

Customer Name (DBA)

Legal Corporate Name

Federal Tax ID Number

Business Contact (signer)

Title

Phone

Fax

Corporate Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

E-Mail Address

Billing Address and Contact Information

AP Contact Name

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Fax

E-Mail Address

Notice Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Current Contract Information

Current Contract End Date

Forms

Electric Cowgirl Forms

Letter of Authorization for the Request of Historical Usage Information Form (English)

AUTHORIZATION

Letter of Representation

Authorization Agreement

Signature

Account Information

Legal Entity Information

Contract Information

Billing Address and Contact Information

Current Contract Information