Corporate Membership Application Instructions

This membership application is for a corporation, partnership, small business, organization or any entity other than a natural person(s) that file their federal tax return using a federal identification number. A privately owned business that files under the owner’s social security number must use the Individual/Joint membership application.

• Please complete the application as indicated on the form.
• A $5.00 membership fee is required to become a member of the Cooperative.
• The $5.00 membership fee will be billed on the first electric statement. The Cooperative will retain the membership fee until you terminate all active electric services.
• If the entity is all or partially sales tax exempt, we will need a copy of the appropriate completed exemption form. This online form includes the ability to upload an exemption document.  
• Upon receipt of the application, a credit report will be ordered and a deposit may be required based on the result.

Our office must receive the completed form and deposit (if required) before the electric service will be connected.

Thank you,
Heartland Rural Electric Cooperative, Inc.

Application and Contract for Membership and Electric Service
CORPORATE OR OTHER ENTITY

This Application and Contract is made between Heartland Rural Electric Cooperative, Inc., (hereinafter called “Cooperative”) and the undersigned, (hereinafter called “Member”).

1. Delivery of Service: Service to be furnished under this Contract will be delivered and received at a location(s) requested by the member and agreed to by the Cooperative.
2. Rate for Service: For the purpose of this Contract, the Member will pay the Cooperative for electric service at rates and upon the terms and conditions set forth in the applicable rate schedule, subject to change by the Cooperative from time to time.
3. Right of Access: Duly authorized representatives of the Cooperative shall be permitted to enter Member’s premises at all reasonable times in order to carry out the provisions of this Contract and for the purpose of installing, reading, inspecting or repairing any meters, devices, electric lines, facilities, and other equipment, to trim trees as necessary to maintain adequate clearance from the Cooperative’s electric lines and equipment, or for any purpose incidental to the electric service supplied by the Cooperative.
4. Term: This Contract shall become effective on the date service is first made available hereunder by the Cooperative to the Member, and shall remain in effect until canceled by either party upon reasonable notification.
5. Deposit: The Cooperative may require at any time, upon proper notice, a cash security deposit, which will bear interest, and be refunded, all in accordance with the Cooperative’s Rules and Regulations. The member agrees to allow the Cooperative to use member’s credit history to determine member’s deposit amount, if any, to connect utility service in member’s name. The Cooperative has a permissible purpose to use member’s credit history in determining the deposit amount as stated in the Federal Credit Reporting Act. The member authorizes the Cooperative to obtain a credit based report to make this determination.
6. Membership in the Cooperative: Through execution of this Contract and agreement to purchase electric energy from the Cooperative, the undersigned will pay to the Cooperative a membership fee of $5.00, and will become a member of the Cooperative. As a member of the Cooperative, Member shall be bound by the Articles of Incorporation, Bylaws, and Rules and Regulations of the Cooperative as they may be altered or amended from time to time. Member acknowledges that they have had the opportunity to review the Bylaws (or have received a copy of the Bylaws) and understand that the Bylaws and Rules and Regulations will remain on file at the Cooperative and are subject to review by the Member during normal business hours.
7. Operation Round Up: Members are enrolled in Operation Round Up, a rounding of the monthly bill with proceeds going to charitable organizations, chosen by the Operation Round Up Board of Trustees, that promote the health and well-being of people in our service area. Members can request to be removed from this program at any time.

To establish your qualification for sales tax exemption, you will need to submit a completed ST-28B form from the Kansas Department of Revenue. If you do not have this form, you can download it here:

DOWNLOAD FORM ST-28B