Diversified - Customer Inquiry Form

Customer Inquiry Form
Customer Name (As it appears on your account)

First NameLast Name
Borough/Municipality/Township That Sends Your Bill
Customer Account Number
Service Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Please Contact Me Using My:
Brief Description Of My Concern

0/150
Please verify that you are human
userid
Before you submit: We can only assist with online profile setup and online payment processing. For all other questions — including billing, account balances, service issues, meter questions, or rate inquiries — please contact your utility company directly. Submitting an inquiry here for those topics will delay a response.
Should be Empty: