Property Owner's Agreement for Automatic Transfer of Service
This form authorizes Platte-Clay Electric Cooperative to revert electric service at the listed rental addresses to the property owner (landlord) between tenants. Signing up for this service will prevent service disconnection between property occupants. Electric bills incurred by the owner at any of their properties that are left unpaid and have become past due will be left to the discretion of Platte-Clay Electric Cooperative and may result in the removal of this agreement. Any unpaid balances on any of the owner's accounts will need to be paid prior to any tenant connecting service at any of the owner's properties.
Property Owner(s)
*
Name of Complex (if applicable)
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Representative Name
*
First Name
Last Name
Representative Email
*
example@example.com
Representative Phone Number
*
Please enter a valid phone number.
Is this property overseen by a management company?
*
Yes
No
Management Company
Management Company Phone Number
Please enter a valid phone number.
Current Occupants
Signature
Notes for Member Services Team
Submit
Should be Empty: