Fill the SSA Form Below SSA Form Form for handling the SSA request. Agent Name* First Last Agent Phone*Agent EmailIntake Form - Property Owner(s)First & Last Name* First Last Mobile Number*Phone Number*Email* Is their a Co-Owner?* Yes No First & Last Name (Co-Owner) First Last Mobile Number (Co-Owner)Phone Number (Co-Owner)Email (Co-Owner) Property DetailsAddress* Street Address City ZIP Code Property Type*SFR/Home2-4 UnitsCondo/TownhouseCommercial/IndustrialCondition of your roof*GreatFairPoorNot sureWhat kind of roof do you have?*TileAsphalt/ShingleWoodNot sureElectric Bills & UsageCurrent Utility Provider*LADWPPG&EPSE&GRoseville ElectricSCESDG&ESMUDMeter NumberAccount NumberEstimated Monthly Electric Bill*Are you participating in any electric company energy subsidy or discount program ?*YesNoIf Yes Specify ProgramFinancing OptionsFinancing Source*Owners have own financing or cashOwners would like to look at financing optionsEstimated Property Value $1st Mortgage2nd MortgageHow's your credit? (Applicant 1)*Great 720+Good 680-719Fair 650-679PoorHave you filed for Bankruptcy in the past 3 years? (Applicant 1)*-YesNoHave you been delinquent on your property taxes in the last 12 months? (Applicant 1)*-YesNoHow's your credit? (Applicant 2)*Great 720+Good 680-719Fair 650-679PoorHave you filed for Bankruptcy in the past 3 years? (Applicant 2)*-YesNoWould you consider refinancing your home loan , if it offered the best terms & payments to purchase solar?*YesNoIs property commercial or industrial?* Yes No If property is commercial or industrial, please list owners name above. If contact should be made first with property manager, please add name & phone here:Schedule Your Phone ConsultationWhat time would you like to schedule a no-obligation phone consultation to review your solar project including cost estimates and financing options?Date* Date Format: MM slash DD slash YYYY File Upload (Optional) Drop files here or Accepted file types: jpg, gif, png, pdf. Upload the required documents only. (file extensions allowed:jpg,gif,png and pdf.)Time* : HH MM AM PM Terms* I have shown the savings presentation to my client in order to complete consultation *Upload Terms I have uploaded the required documentsAdditional CommentsNameThis field is for validation purposes and should be left unchanged. CERTIFIED PREFERRED CONTRACTOR