Common Contracts

Membership and Electric Service Agreement

Service Agreement • August 14th, 2019

• Contract Type
  Service Agreement
• Filed
  August 14th, 2019

Applicant (First Name) (Middle) (Last) D ate Service Requested Co-Applicant (First Name) (Middle) (Last) S tructure Type □ Residence□ Other □ Water Well (metered separately)□ Barn (metered separately) Billing Address O FFICE USE ONLY□ New Location□ Work Order □ Existing Location□ Yard Lights: No. Credit□ Credit Check□ Deposit PenTex FlexPay□ Yes □ No□ Photo ID – Required City State Zip Telephone Number Alternate Number Property□ Own □ Rent Landlord: Account # S.O. # Connect Fee□ Billed□ Paid Applicant: SSN C redit Card Fee $ Total Paid $ By-Laws□ Mailed□ Given in Office Applicant: Employer Phone Co-Applicant: SSN Meter # Co-Applicant: Employer Phone Location # Service (911) Address □ E-Bill□ E-Delinquent□ Standard Mail □ Text Alerts□ E-mail Alerts Operation Round Up®□ Opt In□ Opt Out Email Address SIGN UP FOR ALERTS & REMINDERS TODAYContact our office or visit www.pentex.com