PGW's Natural Gas Heat Conversion Application

Your Information (fields marked with * are required)

Step 1

Enter Account #

Last Name

Step 2 - Where conversion is taking place

Choose a Premise

Change a Premise?

Your Name (Full Name)

Address

City

State

Zip

Step 3 - Where Credit is being applied

Enter Account

Last Name

Select Premise

Same Address as above

Address

City

State

Zip

Phone

Landlord Rental License ID (if applicable)

Installer Information

Step 4

Installer Name

Installer Phone

Installer Address

City

State

Zip

Date of Installation

Equipment Details

Step 5

Make

Model

BTU Input

Efficiency Rating

Number of apartments (if applicable)

Do you plan on converting any other appliances to natural gas within this year?

Water heater

Range

Furnace/Boiler

Dryer

Fireplace

Outdoor grill

Other

None

Attachments

Step 6

Please attach a copy of your signed contract and a paid-in-full invoice outlining the equipment details and all work completed. Individual attachment size not to exceed 2 MB; total attachment limit 10 MB. Allowed: .gif, .jpg, .png, .pdf, .txt, .bmp, .doc, .docx, .jpeg.

Optional: Notes or Comments

User verification required