Case of PA Smart Meters – Amici Form • Protecting Children’s Health


A. Contact Information

name*





B. For Organized Organizations:

2. State of Incorporation:

4. Does the organization belong to another corporation (parent Corp) or have affiliates with other corporations (e.g., subsidiaries)?*
6. Is there a corporation that holds more than 10% of the stock in your corporation?
7. Did your corporation receive money from anyone to participate or for the preparation of the amicus brief?

Limit your mission statement to 200 words.

12. Does your corporation work with people who need to have a smart meter opt-out for health reasons?

C. For non -union organizations:

2. City and State
3. Is your organization affiliated with or part of a corporation?
5. Are you affiliated with other organizations?
7. Did your organization receive money from anyone to participate or for the preparation of the amicus brief?
12. Does your organization work with people who need to have a smart meter opt-out for health reasons?

D. If you have additional information or comments, please write them here:



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