Farmers Rural Electric - A Touchstone Energy© Cooperative

Farmers RECC request to connect to an existing service.:

Application date:
Address of service desired:
Meter number at service location:
Please tell us what this meter serves:
Service Start Date Requested (mm/dd/yy:
Applicant's First Name:
Applicant's Middle Initial:
Applicant's Last Name:
Applicant’s employer:
Applicant’s Phone number (home):
Applicant’s Phone number (cell):
Applicant’s Phone number (work):
Applicant’s E-mail address:
Applicant’s New address:
Co-Applicant’s First Name:
Co-Applicant’s Middle Initial:
Co-Applicant’s Last Name:
Co-Applicant’s employer:
Co-Applicant’s Phone number (home):
Co-Applicant’s Phone number (cell):
Co-Applicant’s Phone number (work):
If there is a security light at the new location, would you like it to be connected? (Yes or No):
Are you interested in automatic bank/credit card draft? Yes or No:
Do you own this property? If not, please list the owner’s name, address, and telephone number:
Person requesting service: