ENERGY CERTIFICATES

Need a gift idea? How about a UGI Energy Certificate? Energy certificates can be in any denomination and are the perfect way to show someone that you care.

Print this form and complete the information below. Mail this form, with your check, to:

UGI Customer Outreach
225 Morgantown Road
P.O. Box 13009
Reading, PA  19612-3009

A Gift From:

Name
Address
City
State
Zip
Daytime Phone
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________

Recipient:

Name
Address
City
State
Zip

Amount of Energy Certificate
___________________________
___________________________
___________________________
___________________________
___________________________



$_
_________________________
Customer Number
___________________________

All gifts are credited directly to the Recipient's account. Notification and an energy certificate (receipt) will be sent.

Would you like the energy certificate mailed to:

[    ] Gift From?

[    ] Recipient?

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Payment Type: 605 (For Office Use Only)