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IDT Energy Sales Agreement and Letter of Authorization

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SERVICES

Your Electric Utility Company*	Select one Central Hudson Consolidated Edison Keyspan National Fuel Gas National Grid Orange & Rockland Rochester Gas & Electric	Electric Account #*
Your Gas Utility Company*	Select one Central Hudson Consolidated Edison Keyspan National Fuel Gas National Grid Orange & Rockland Rochester Gas & Electric	Gas Account #*

Services you want from IDT Energy?	Gas      Electric      Both
Do you want Green Energy?	Yes       No

PERSONAL INFORMATION

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Last Name*
Account Type*	Residential      Business
Company Name (if commercial)
Service Address*		Billing Address*
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