This form contains 157 fields organized into 36 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Account / Meter Identification (District/Prefix/Suffix/Effective Date)
Meter Identification Cycle Text
Enter the cycle code associated with the account/meter identification.
District Code (Digit 1) Text
Enter the first digit of the district code for the account/meter identification.
District Code (Digit 2) Text
Enter the second digit of the district code for the account/meter identification.
Meter Number Prefix Text
Enter the prefix portion of the meter number.
Meter Number Suffix Text
Enter the suffix portion of the meter number.
ADDRESS_Row_2 Text
Effective Date Month Text
Enter the month of the effective date for this account/meter identification.
Max length: 2 characters
Effective Date Day Text
Enter the day of the effective date for this account/meter identification.
Max length: 2 characters
ADDRESS_Row_2 Text
Effective Date Submitted By Text
Enter the initials or identifier of the person who submitted the effective date change.
Additional Information
Additional Information 1 Text
Enter the first line of any additional notes or details relevant to this application.
Additional Information 2 Text
Enter the second line of any additional notes or details relevant to this application.
Additional Information 3 Text
Enter the third line of any additional notes or details relevant to this application.
Applicant Name and DBA
Applicant Corporate or Individual Name Text
Enter the legal name of the applicant (corporation, business entity, or individual) requesting the electric service.
Applicant DBA (Doing Business As) Text
Enter the applicant’s DBA or trade name, if different from the legal name.
Applicant Residence Address
Applicant Residence Address Text
Enter the applicant’s full residence address (street address, and any unit or apartment number).
Applicant Signature Block (Date, Signed By, Title, Witness, Office of Origin)
Applicant Signature Date Date
Enter the date the applicant signed this application/contract.
Signed By Text
Enter the full name of the person signing on behalf of the applicant.
Signer Title Text
Enter the job title or official position of the person signing.
Witness Name Text
Enter the full name of the witness to the applicant’s signature.
Office of Origin Text
Enter the name of the office or department where this application originated.
Business / Applicant Identification
Corporate or Individual Name Text
Enter the full legal name of the applicant business or individual.
DBA Name Text
Enter the business’s “doing business as” (trade) name, if different from the legal name.
Business Telephone Number Text
Enter the primary telephone number for the business.
Completion (Field/BKPG)
Completed BKPG Date Date
Enter the date the back-office/booking (BKPG) work was completed.
Completed Field Date Date
Enter the date the field work was completed.
Completed Field By Text
Enter the name or initials of the person who completed the field work.
Completed BKPG By Text
Enter the name or initials of the person who completed the back-office/booking (BKPG) work.
Contract Demand and Excess Transformer Capacity
Contract Demand (kW) Number
Enter the contract demand value for the temporary electric service.
Excess Transformer Capacity (kVA) Number
Enter the excess transformer capacity value applicable to the service.
Credit Department Approval / Date Wanted
Credit Department Approval Text
Enter the name or identifier of the credit department representative approving this request.
Date Wanted Date
Enter the requested date when the service or action is wanted.
Cycle/Book/Folio/Cust. No. Reference
District Text
Enter the district code associated with the account reference.
Book Text
Enter the book number used as part of the account reference.
Max length: 9 characters
Folio Text
Enter the folio number used as part of the account reference.
Cycle Text
Enter the cycle identifier used for the account reference.
Equipment / Demand Meter Details (Section 6)
Section 6 - RES (Equipment) Text
Enter the value for the RES field in Section 6 to indicate the residential equipment/load information for the premises.
Max length: 1 characters
Section 6 - W.T.H (Water Heater) Text
Enter the value for the W.T.H field in Section 6 to record the water-heater equipment/load information.
Max length: 1 characters
Section 6 - RANGE Text
Enter the value for the RANGE field in Section 6 to record the range/oven equipment/load information.
Section 6 - HEAT Text
Enter the value for the HEAT field in Section 6 to record the heating equipment/load information.
Section 6 - AIR C (Air Conditioning) Text
Enter the value for the AIR C field in Section 6 to record the air-conditioning equipment/load information.
Max length: 1 characters
Section 6 - D.M. PR. RES Number
Enter the demand-meter value for the D.M. PR. RES field in Section 6.
Max length: 3 characters
Section 6 - D.M. RANGE Number
Enter the demand-meter value for the D.M. RANGE field in Section 6.
Max length: 3 characters
Section 6 - D.M. WTR. H Number
Enter the demand-meter value for the D.M. WTR. H field in Section 6.
Max length: 3 characters
Section 6 - D.M. HEAT Number
Enter the demand-meter value for the D.M. HEAT field in Section 6.
Max length: 3 characters
Section 6 - D.M. AIR C Number
Enter the demand-meter value for the D.M. AIR C field in Section 6.
Max length: 3 characters
Equipment to Be Served - First Row (Lighting)
Lighting Equipment Description Text
Enter a description of the lighting equipment to be served (e.g., type or purpose of the lighting load).
Lighting Phase Text
Enter the electrical phase for the lighting load.
Lighting kVA Number
Enter the total kilovolt-ampere (kVA) required for the lighting load.
Lighting kW Number
Enter the total kilowatts (kW) required for the lighting load.
Lighting HP Number
Enter the total horsepower (HP) required for the lighting load.
Equipment to Be Served - Fourth Row
Fourth Row Equipment Description Text
Enter the description of the equipment to be served for the fourth row of the table.
Fourth Row Phase Text
Enter the electrical phase information for the equipment listed in the fourth row.
Fourth Row kVA Number
Enter the connected load for the fourth-row equipment in kVA.
Fourth Row kW Number
Enter the connected load for the fourth-row equipment in kW.
Fourth Row HP Number
Enter the horsepower rating for the fourth-row equipment.
Equipment to Be Served - Second Row
Second Row - Equipment to Be Served Text
Enter the description of the equipment to be served for the second row of the equipment table.
Second Row - Phase Text
Enter the phase information for the equipment listed in the second row.
Second Row - kVA Number
Enter the kVA rating for the equipment listed in the second row.
Second Row - kW Number
Enter the kW rating for the equipment listed in the second row.
Second Row - HP Number
Enter the horsepower (HP) rating for the equipment listed in the second row.
Equipment to Be Served - Third Row (Power)
Third Row (Power) - Equipment Description Text
Enter the name or description of the power equipment to be served.
Third Row (Power) - Phase Text
Enter the phase configuration for the power equipment to be served.
Third Row (Power) - kVA Number
Enter the total apparent power rating in kVA for the power equipment to be served.
Third Row (Power) - kW Number
Enter the total real power requirement in kW for the power equipment to be served.
Third Row (Power) - HP Number
Enter the total horsepower rating for the power equipment to be served.
Estimated Removal/Sum and Salvage Values
Estimated Removal/Salvage Sum (Written Amount) Text
Enter the total estimated amount for removal cost minus salvage value written out in words.
Estimated Removal/Salvage Sum (Dollar Amount) Number
Enter the total estimated amount for removal cost minus salvage value as a dollar amount.
Form of Business Organization
Sole Proprietorship Checkbox
Check this box if the business is owned and operated by one individual and is not incorporated or a partnership.
Corporation Checkbox
Check this box if the business is legally organized as a corporation (incorporated entity).
General Partnership Checkbox
Check this box if the business is a general partnership where partners share ownership and management responsibilities.
Co-Partnership Checkbox
Check this box if the business is organized as a co-partnership (a partnership arrangement between co-owners).
Other Business Organization (Specify) Text
Enter the form of business organization if it is not one of the listed options (e.g., LLC, nonprofit, trust).
Type of Business Text
Describe the type of business activity performed (e.g., processing, manufacturing, retail, services).
Former Business Service Address Reference
Former Business Service Address Cycle Text
Enter the utility/account cycle identifier associated with the former business service address.
Former Business Service Address District Text
Enter the district code associated with the former business service address.
Former Business Service Address Book Text
Enter the book reference number associated with the former business service address.
Former Business Service Address Folio Text
Enter the folio reference number associated with the former business service address.
Former Business Service Address CR CD Text
Enter the CR/CD reference code associated with the former business service address.
Former Business Service Address Text
Enter the complete former business service address being referenced.
General
BOOK_ Text
BOOK_ Text
BOOK_ Text
FOLIO_Row_1 Text
FOLIO_Row_1 Text
FOLIO_Row_1 Text
FOLIO_Row_1 Text
CUST. NO._Row_1 Text
CUST. NO._Row_1 Text
Hours of Operation / Square Footage
Hours of Operation Text
Enter the business hours of operation for the service location.
Square Footage Number
Enter the total square footage of the premises.
Immediate Previous Edison Service Address (Section 7)
Section 7 Previous Edison Service Address Text
Enter the full street address for the immediate previous Edison service location.
Max length: 23 characters
Section 7 Installation Code Text
Enter the installation code associated with the immediate previous Edison service address.
Section 7 Location Code Text
Enter the location code associated with the immediate previous Edison service address.
Section 7 Multiple Accounts Code Text
Enter the multiple-accounts indicator/code for the immediate previous Edison service address.
Section 7 Copies Text
Enter the number of copies requested/required for this service record.
Section 7 Work Order Code Text
Enter the work order code tied to the immediate previous Edison service address, if applicable.
Section 7 City Text
Enter the city for the immediate previous Edison service address.
Internal Routing / Accounting Codes
Return to Accounting Code Text
Enter the internal code or notation indicating how this form should be routed/returned to the Accounting department.
Internal Routing / Accounting Reference Text
Enter any internal routing or accounting reference code associated with this request.
FSR Area Number Text
Enter the F.S.R. area number used for internal routing/accounting purposes.
Mailing Address (Section 8)
Section 8 Mailing Address Line 1 Text
Enter the first line of the Section 8 mailing address (e.g., street address or P.O. box).
Max length: 19 characters
Section 8 Mailing Address Line 2 Text
Enter the second line of the Section 8 mailing address (e.g., apartment, suite, unit, or additional address information).
Max length: 19 characters
Section 8 Mailing Address Line 3 Text
Enter the third line of the Section 8 mailing address (e.g., city and state or any remaining address details).
Max length: 13 characters
MAILING ADDRESS_Row_2 Text
Section 8 Mailing Address ZIP Code Text
Enter the ZIP code for the Section 8 mailing address.
Max length: 5 characters
Meter Read / Deposit / Demand Read (Section 6)
Section 6 Name Text
Enter the name associated with this meter read/deposit/demand read record.
Max length: 19 characters
Section 6 Meter Read Number
Enter the meter reading value.
Max length: 5 characters
Section 6 CR. CD Text
Enter the CR. CD code shown for this account or service.
Section 6 SP HND Text
Enter the SP HND (special handling) code or notation for this service.
Max length: 1 characters
Section 6 DP REQ Text
Enter the DP REQ (deposit required) indicator or code.
Max length: 1 characters
Section 6 Deposit Amount Number
Enter the deposit amount required for the service.
Section 6 By H.L. Text
Enter the initials or identifier for the person marking the entry as 'By H.L.'.
Section 6 GSP Text
Enter the GSP value or code for this service.
Section 6 Demand Read Number
Enter the demand reading value.
Max length: 4 characters
Order Taken
Order Taken At Time
Enter the time when the order was taken.
Order Taken By Text
Enter the name or identifier of the person who took the order.
Order Taken Date Date
Enter the date when the order was taken.
Owner of Premises Contact
Owner of Premises Name Text
Enter the full name of the owner of the premises.
Owner of Premises Telephone Number Text
Enter the telephone number for the owner of the premises.
Owner of Premises Address Text
Enter the street address for the owner of the premises.
Owner of Premises Address (Line 2) Text
Enter any additional address details for the owner of the premises, such as city, state, ZIP code, unit, or suite.
Partner/Officer (First Entry)
First Entry Partner/Officer Name Text
Enter the full name of the first listed partner or corporate officer.
First Entry Partner/Officer Address Text
Enter the mailing address for the first listed partner or corporate officer.
First Entry Partner/Officer Telephone Number Text
Enter the telephone number for the first listed partner or corporate officer.
Partner/Officer (Second Entry)
Second Partner/Officer Name Text
Enter the full name of the second partner or corporate officer.
Second Partner/Officer Address Text
Enter the mailing address for the second partner or corporate officer.
Second Partner/Officer Title Text
Enter the job title or position held by the second partner or corporate officer.
Second Partner/Officer Telephone Number Text
Enter the telephone number for the second partner or corporate officer.
SCE Approval Signature (Manager)
SCE Approval Signature (Manager) - By Text
Enter the name of the SCE manager (or authorized representative) approving and accepting the application on behalf of Southern California Edison.
Service Address
Service Address Street Text
Enter the street address where service is provided (street number and street name).
Service Address Post Office Text
Enter the service address post office information, such as a P.O. Box number if applicable.
Service Deposit Information
Deposit Number Text
Enter the identifier or reference number assigned to the service deposit.
Deposit Amount Number
Enter the dollar amount of the service deposit.
Service Deposit Date Date
Enter the date associated with the service deposit.
Applicant Initials Text
Enter the applicant’s initials to acknowledge the service deposit information.
Service Location Address (Section 6)
Section 6 Service Address Street Text
Enter the street address for the service location (house number and street name).
Max length: 20 characters
Section 6 Service Address Apt No. Text
Enter the apartment, unit, or suite number for the service location, if applicable.
Max length: 3 characters
Section 6 Service Address Post Office Text
Enter the post office/city associated with the service location address.
Section 6 Service Address City Text
Enter the city for the service location address.
Section 6 Service Address State Text
Enter the state for the service location address.
Section 6 Service Address ZIP Code Text
Enter the ZIP code for the service location address.
Service Request Details (Type/Schedule/Cross Street/Meter Order/Load Check)
Service Type - Light Text
Enter the requested service type value associated with the “LIGHT” option.
Schedule Text
Enter the service schedule or timing information for the requested work.
Nearest Cross Street Text
Enter the nearest cross street to the service location.
Service Type - Power Text
Enter the requested service type value associated with the “POWER” option.
Meter Order Number Text
Enter the meter order number associated with this service request.
Service Type - New Set Text
Enter the requested service type value associated with the “NEW SET” option.
Load Check Text
Enter the load check details or reference information for this service request.
Service Schedule (Hours and Months)
Service Schedule Hours Number
Enter the total number of hours of temporary electric service requested under this schedule.
Service Schedule Months Text
Enter the minimum number of months that temporary electric service is requested for under this schedule.
Service Voltage, Connected Load, and Estimated Max Demand
Service Voltage Text
Enter the service voltage to be provided for the temporary electric service.
Connected Load Number
Enter the total connected electrical load for the equipment to be served.
Estimated Max Demand Number
Enter the estimated maximum electrical demand expected for this temporary service.
Work Order / Lookup Numbers
Lookup Number Text
Enter the lookup number used to identify or reference this request in the utility’s system.
D.W.O. Number Text
Enter the D.W.O. (work order) number associated with this job or service request.
C.W.O. / C.J.O. Number Text
Enter the C.W.O. or C.J.O. number associated with this work order or job order.