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Membership Agreement & Application for Service

If you wish to reconnect electric service or transfer billing responsibility of an active electric service, please call our office during business hours:  7:30 am - 4:00 pm, Monday through Friday.  You MUST have the meter number available when you call. This 8- or 9-digit number can be found behind the glass of the meter at the location.  Please do not submit this form before contacting our office; you will need to provide your social security number prior to beginning this process.  All requirements necessary for your request will be disclosed to you at that time.

 

Claverack Rural Electric Cooperative, Inc. offers this electronic form to prospective members of the cooperative for their convenience.  A hard copy of this form is available for completion at our main office or can be requested by mail.

 

For requests to reconnect electric service, this form and any other requirements (i.e. deposit, easement form, etc.) must be received at our office for processing. 

For requests to transfer billing responsibility of an active electric service, this form and any other requirements (i.e. deposit, easement form, etc.) must be received in our office within 30 days after the requested date to transfer billing responsibility to avoid disconnection of your electric service.

 

*** You will receive a confirmation message once all required information* is entered on this form and submitted.***

 

Type your name as you would sign it.
If application is made for joint membership, both applicants must sign.
FOR OFFICE USE ONLY:
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