Get Application For Membership/electric Service - Ljec.coop

Filling out the application for membership and electric service with Leavenworth-Jefferson Electric Cooperative can seem daunting. This guide aims to streamline the process by providing clear and comprehensive steps to assist you in completing the application online.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Select the membership type by marking the appropriate box, indicating whether you are a current member or a new member.
3. If the applicant is a business, select the relevant type of business structure by marking the corresponding box.
4. Indicate whether the applicant is the owner or a renter. If renting, provide the name of the property owner.
5. Fill in the requested date for the service connection or transfer.
6. Provide the applicant's full name, Social Security number, and if a business, the employer identification number.
7. Enter the birth date of the applicant and the employer's name.
8. Fill in the phone numbers: home, work, and mobile. Additionally, enter a valid email address.
9. If applicable, provide details for an additional name, including their Social Security number, birth date, employer, and contact numbers.
10. Complete the mailing address section and, if the service location is different, provide the 911 service location address.
11. Indicate if there are rental space lights at the location. If yes, specify whether to connect/disconnect or leave on/off.
12. Select the type of structure at the service location by checking all that apply.
13. Review the section on deposits and select an option based on your credit history or other applicable circumstances.
14. Read the terms and conditions carefully. To proceed, provide signatures where indicated, including additional signatures if necessary.
15. Finally, you may save changes, download, print, or share the document as needed.

Complete your application for membership and electric service online today!