Wiring Affidavit

This form should only be filled out by an electrical contractor or wireman. If you have any questions, please call 800-831-8629.

Customer Name*
First Last
Service Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County*
ACEC Service Order Number
ACEC Location Number
Electrical Contractor or Wireman*
Company or Firm (if applicable)
License Number*
Daytime Phone Number of Electrician or Wireman
Street Address of Electrical Contractor or Wireman*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Residential or Commercial Service*
- Residential (One and Two Family)
- Commercial
Type of Service*
- New
- Upgrade
- Relocate
Entrance Size (amps)*
Service Entrance Conductor Size*
Overheard or Underground Service*
- Overhead Service
- Underground Service
Single Phase or Three Phase Service?*
- Single Phase
- Three Phase
Desired Voltage*
- I agree to submit this form electronically and hereby authorize ACEC to verify the information in this form. By agreeing, it indicates I am the electrical contractor or wireman who did the wiring for electricity on the above premises and that all of said described electric wiring at the location above was done to comply and does comply with the Wisconsin Electrical Code, and that this written statement is made pursuant to and in compliance with the provisions of Sec. 101.865 of Wisconsin Statutes. Energizing the described wiring will in no way create a hazard.