Text Size
Increase text size
Increase text size

Consent Form to Disclose Utility Customer Data

   

Consent Form to Disclose Utility Customer Data pdf file

 All requested information must be provided for the consent to be valid.


TO BE PROVIDED BY RECIPIENT OF CUSTOMER DATA:

See specific instructions on form: Provide to the utility service provider and the customer prior to disclosure the following documents and information:

  • A statement describing Company’s business structure (corporation, limited liability company, partnership, sole proprietorship, etc.)

  • If Company is a corporation: the name of the state in which Company is incorporated; the location of its principal office, if any, in Colorado; the names of its directors and officers; and a certified copy of its certificate of good standing authorizing it to do business in Colorado, certified within 6 months prior to the submission of this Consent Form

  • If Company is a limited liability company: the name of the state in which Company is organized; the complete mailing address and physical address of its principal office; the name of its managers; and a certified copy of its certificate of good standing authorizing it to do business in Colorado, certified within 6 months prior to the submission of this Consent Form

  • If Company is a partnership: the names, titles, and addresses of all general and limited partners; and a copy of the partnership agreement establishing the partnership and all subsequent amendments

Specify the data to be released and description of use (please be specific and fill in all blanks):  

  • See specific instructions on form: Company should describe the customer data to be provided in a detailed and clear enough manner to inform the customer and the utility of (1) the specific types of data requested, and (2) the purposes for which the data will be used. (Example—"We seek monthly electricity usage data for the household, in order to show the net gain in efficiency resulting from our energy efficiency upgrades, and we will use this data, aggregated with other customers, to display the results in print and television marketing.")

Connect

facebook twitter

Contact

1560 Broadway, Suite 250, Denver, CO 80202
(303) 894-2000 - Phone (800) 888-0170 - Permits and Insurance (800) 456-0858 - Consumer Assistance (303) 894-2065 - Fax