Customer Information Disclosure Authorization
Because of recent changes in requirements that apply to disclosures of information about customers by utilities, HomeSmart from Xcel Energysm is requesting that you complete this consent form to authorize your utility service provider -- Xcel Energy -- to continue to disclose certain information about you to HomeSmart. Xcel Energy cannot release your information to HomeSmart without your consent. This form describes the information to which we require access and the reasons we are asking for this information.
The information maintained by Xcel Energy to which HomeSmart requires access includes your name, the identity of the customer of record for your premise and other individuals authorized to act on your behalf; the address where you receive service from Xcel Energy and your billing address (if different); your phone number; and Xcel Energy account number and account status. HomeSmart does not access your Social Security Number or your energy usage data maintained by Xcel Energy.
How We Will Use Your Information
We use the information to provide and bill for HomeSmart services that you request.
You are not required to authorize the disclosure of your information to HomeSmart, and your decision not to authorize the disclosure will not affect the utility services you receive from Xcel Energy. However, if you do not authorize the disclosure, we will be unable to continue to provide you with HomeSmart services. Your consent is valid (1) for one year; or (2) until the expiration of your relationship with HomeSmart, which is until we have billed and collected any amounts due for the services you have received from HomeSmart; or (3) until terminated by you, whichever is earlier. You may terminate your consent to the release of additional data by Xcel Energy to HomeSmart at any time by sending a written request with your name and service address to HomeSmart at 825 Rice Street, St Paul, MN, 55117, or email@example.com, clearly stating that you want to terminate your consent. Withdrawing your consent will not affect information that already has been released to HomeSmart. If you terminate your consent before the expiration of your relationship with HomeSmart, it will prevent HomeSmart from providing products or services to you going forward, but you will continue to be responsible for the total remaining monthly payments in your contract.
By signing this form, you acknowledge and agree that you are the customer of record for this account and that you authorize Xcel Energy to disclose your information as specified in this form.