Transfer Service

Name *

First

Middle

Last

Email *

Phone *

Current Service Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date To Turn Off Current Service Address *

You Can Leave Service On Both Accounts For Two Weeks Maximum Without Another Deposit

New Service Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Last 4 Numbers of Social Security Number *

This Is For Identification Purposes

Employer *

I Agree To Your Terms And Conditions *

I Agree

The undersigned (and spouse if applicable) (jointly the “Customer”) hereby applies to Marshall-DeKalb Electric Cooperative (“MDEC”) for membership and electric service and certifies the information provided to be correct. The Customer (and Spouse), jointly and severally agree to the following provisions: 1. At time of application, Customer will pay a refundable membership fee of $5.00 and a security deposit of $ (depends on credit check) ¬¬ which will be refundable, without interest, if not forfeited to pay for delinquent bill or other damages. Connection fees and construction fees are not refundable. 2. Customer will pay for all power and energy used at the property, as determined by MDEC, per the applicable rate schedule, as adjusted from time to time, plus a late charge of 5% if not received by MDEC (not merely postmarked) by the “Due Date” as indicated on the Customer’s bill, plus a fee of $3.00 if not received within 2 days after said Due Date. 3. MDEC is hereby granted an easement to install and maintain its equipment, to access its meter (24 hours per day) and to trim and/or remove any vegetation MDEC determines necessary to prevent interruption of service. 4. MDEC may deny service if it detects a safety hazard in the Customer’s appliances or wiring or a violation of MDEC’s rules and regulations but is not under a duty to inspect the Customer’s premises. 5. Customer will not tamper with, adjust or relocate MDEC’s meter or any of its equipment. 6. Customer agrees to pay MDEC’s expenses and attorney fees incurred in enforcing this agreement or in collecting any sums due for services

Comment or Message *

Name

Note: Your current account must have a zero balance to transfer. The $10 transfer fee will be added to the first bill at the new location. The final bill for your current address will be calculated from the final reading and due 20 days from the date of disconnect. It will be mailed to your new address.

Pay Your Bill