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Personal Information
First Name
Last Name
Email
Phone
Preferred Language:
English
Spanish
Portuguese
Do you receive the R2 or R4 discounted electric rate?
Yes
No
I'm not sure
Building Information
Street
City
Zip
Gas Utility:
--None--
Eversource
National Grid
Berkshire Gas
Blackstone
Electric Utility:
--None--
Eversource
National Grid
Unitil
Municipal
Primary Heating Fuel:
--None--
Gas
Oil
Electric (Resistance)
Electric (Heat Pumps)
Geothermal
Other
Biofuel
Who occupies this building?
You
Tenant
Both
Numbers of unit in Building:
--None--
1
2
3
4
5
5-10
>10
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