Electric and Propane Service Application | Polk-Burnett Electric Cooperative

Wednesday February 24 - CHANCE of Full Load Control from 7 a.m. - 11 a.m. for participating electric heat.

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Starting service for a(n)

Date to begin service in my name

Applicant

Applicant Type

Natural Person

Organization

Applicant name (first & last or business name)

Federal ID #

State of Incorporation

Email address

Primary phone #

Secondary phone #

Co-applicant

Co-applicant name (first & last)

Co-applicant email address

Primary phone #

Secondary phone #

Service location

Fire # and street name (or parcel ID for new services)

City, State, ZIP Code

Own or rent

Type of service

Billing address (if different from above)

Mailing address

City, State, ZIP Code

Polk-Burnett Propane

Would you like Polk-Burnett Propane?

Yes

The billing for electric and propane are separate.

POLK-BURNETT ELECTRIC COOPERATIVE