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Agent Form
Agent Enrollment Form
[sofed-lonestar-agent-tools-app][/sofed-lonestar-agent-tools-app]
Please complete the enrollment form with the customer on the phone.
AGENT ID
Agent ID
(Required)
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ACCOUNT INFO
ESI-ID
(Required)
This is a 17 or 22 digit number that identifies their meter and is found on the Electric Bill. Use the
Service Location Search
tool above to locate a valid ESIID.
CONTACT NAME
Billing Name
(Required)
First
Middle
Last
Relationship To Account Holder
(Required)
Account Holder
Spouse
Son / Daughter over 18 Years Old
Authorized Name
(Required)
First
Last
Date of Birth (Account Holder)
(Required)
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CONTACT INFO
Primary Phone Number
(Required)
Phone Type
(Required)
Mobile
Home
Alternative Phone Number
Phone Type (Alternative)
Mobile
Home
Other
Email (Account Holder)
(Required)
Enter Email
Confirm Email
Notifications
I want to receive promotional information about products and services via text message.
Notifications will be sent via automated text message. Message and data rates may apply.
Add A Secondary Account Holder
YES
Name (Secondary Holder)
First
Middle
Last
Date of Birth (Secondary Holder)
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
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11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
What Language would you like us to use for future communications?
English
Spanish
Your Service Information
Service Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Reason for Enrollment
(Required)
Move-in
Switch
Requested Service Start Date (No Weekends / No Holidays)
(Required)
MM slash DD slash YYYY
Minimum (
10
Business Days) - Maximum (120 Business Days). Exclude Weekends and Holidays.
Billing Information
Billing Information Is Different
My billing address is DIFFERENT than my Service Address
Billing Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Method Of Billing
(Required)
Paper Billing Only
Electronic Billing Only
Both Paper and Electronic Billing
Hidden
FORM DISPOSITION
Hidden
Disposition
Abandon
Submit
Email
This field is for validation purposes and should be left unchanged.