Residential Service Application

Physical Address of Service Location

Address 2

City/Town

State/Province

ZIP/Postal Code

Addition

Lot

Block

Main Applicant

First

Middle

Last

Date of Birth

Driver’s license/State

Email Address

Business Phone

Home/Primary Phone

Cell Phone

Mailing address for bill statement same as service location?

Yes

Mailing address for bill statement

Address 2

City/Town

State/Province

ZIP/Postal Code

Drivers License

Upload requirements

Main Applicant Signature

Sign above

Printed Name

Date & Time

Do you have a co-applicant?

Yes

Co-Applicant

First

Middle

Last

Co-Applicant Date of Birth

Co-Applicant Driver’s license/State

Co-Applicant Email Address

Co-Applicant Business Phone

Co-Applicant Home/Primary Phone

Co-Applicant Cell Phone

Co-Applicant Drivers License

Upload requirements

Co-Applicant Previous Mailing Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Co-Applicant Signature

Sign above

Co-Applicant Printed Name

Co-Applicant Date & Time

Additional Questions

Is there already a meter(s) at this location?

Yes

Name of Previous Occupant

Date of Transfer

Meter Number

Meter Number2

Meter Number3

Have you already been in contact with a staking technician?

Yes

Staking Technician Name

Applicant agrees to become a member and comply with and be bound by the Cooperative’s articles of incorporation, bylaws and tariffs, including rate schedules and service rules. Rates may be changed by the Cooperative’s board of directors in the manner provided by law. Member shall grant to Cooperative written easement(s) satisfactory to the Cooperative that are necessary for a cooperative purpose including providing electric service to Member or other members or applicants for the Cooperative’s service. Access is required for inspection and line maintenance purposes. Member/Consumer agrees to provide access for all utility purposes. Member/Consumer agrees to allow Fannin County Electric Co-op. to install a lock if there is or ever shall be a locked gate at this location.

All Applicants subject to ID verification and credit report review. False, inaccurate or incomplete information will invalidate the application until discrepancies are resolved.

Please allow up to 3 business days from the initial scheduled date for connection of an existing service location.

YOU WILL BE CONTACTED BY PHONE OR E-MAIL FOR TOTAL BALANCE OF FEES DUE (WHICH MAY INCLUDE A SECURITY DEPOSIT AND/OR CONNECTION FEES), YOUR ACCOUNT NUMBER AND PAYMENT METHODS.

Terms of Agreement

I agree to the terms of service.

Agreement

By clicking “I agree” or otherwise electronically submitting this application, you affirm that you agree with the terms hereof and that you are executing this application and intending to attach your electronic signature to it. Upon acceptance by the Cooperative, your submitted application will constitute a contract under Texas law.

Remarks

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OUTAGE REPORTING: 903.583.2117 | 1.800.695.9020

Residential Service Application