Consumer Information Energy Telecommunications
Elizabeth S. Jacobs
Chair
Nick Wagner
Board Member
Sheila K. Tipton
Board Member

RR/Utility Emergency Contact Information Form

If you have more than three emergency contacts, you will not be able to use this form. If you cannot or choose not to use this form, please mail an original and two copies of your contact information to: Executive Secretary, Iowa Utilities Board, 1375 E. Court Ave., RM 69, Des Moines, Iowa 50319-0069.

Items marked with a red asterisk (*) are required fields. Please note: Information filed via this form is subject to the Freedom of Information Act and will be open for public inspection.

*Company name:
*Business address:
*City:
*State: *Zip Code:

Information in this shaded area will not be published in the contact lists.  This information is for internal use only.

*Name of person to contact with questions about this form:

*Business Phone:
*E-mail address:

*Type of Company
      If other, please describe  

*Emergency Contact 1 - 
*Primary phone:    After-hours:    Mobile/Cell: 

Pager:

Other info.:  

 Emergency Contact 2 - 

Primary phone:    After-hours:   

Mobile/Cell: 

 Pager:

Other info.:  
 Emergency Contact 3 - 
Primary phone:    After-hours: 

Mobile/Cell: 
 Pager:

Other info.:  
  
The emergency contact information lists are being updated approximately once each month.  Once the new list is posted, please review your information to verify that it has been submitted and input correctly.