Know my personal information request

First name of requestor

Last name of requestor

Email of requestor

Confirm email of requestor

Phone number of requestor

Select your preferred contact time

9am-12pm 12pm-5pm 5pm-9pm

Are you a California resident?

Yes

Last name on Reliant account

Street number of service address

Email of Reliant account holder

Date of birth of Reliant account holder

First name

Last name

Email Address

Confirm email address

Phone number

Select your preferred contact time

9am-12pm 12pm-5pm 5pm-9pm

Address

City

State

Zip

Are you a California resident?

Yes