Customer Information Form – Disaster Support

Contact Information: Please provide your best contact information in case we need to reach you during the disaster

*Denotes a required field.






* Mailing Address








SCE Account Information: Please complete this section to the best of your ability


SCE Account Holder:




* Service Account Address (i.e. the address where you receive your SCE electric service)




Property Disaster Assessment



Please list any additional addresses on your property

Clear Address





Property Disaster Assessment

Clear Address





Property Disaster Assessment

Clear Address





Property Disaster Assessment

Disaster Details: Please complete this section to the best of your ability