Application for Third Party Notice

By completing this form, I request that the third party (person or 
agency) named below be notified of any Non-Payment Disconnect Order 
issued by Atlantic City Electric against my account.


     Customer Name __________________________________________

    Atlantic City 
    Electric 
    Account Number __________________________________________


           Address __________________________________________
	

             Phone __________________________________________


              City __________________________________________
	
	
             State __________________________________________
	

               Zip __________________________________________



Customer Signature __________________________________________


  Third Party Name 
       (person or 
           agency) __________________________________________


           Address __________________________________________
	

             Phone __________________________________________


              City __________________________________________
	
	
             State __________________________________________
	

               Zip __________________________________________


      Signature of 
       Third Party __________________________________________