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Our system will perform maintenance on the third Thursday of each month from 8pm to 1am.
During this time payments cannot be made on our website, over the phone, or thru SmartHub.

Rental or Lease Authorization Form

Please enter the data requested below:

I (we) are renting/leasing the property at the following service address and authorize the Cooperative to connect service at this location. I am (we are) the primary tenant / resident at this location:

Service Address

City

State

Date to be connected in Tenant(s) name:

Tenant #1

First Name

Last Name

Phone Number

Confirm email

Is there a second tenant?

Tenant #2

First Name

Last Name

Phone Number

Confirm email

Are you working directly with the property owner or a property manager?

Property Owner Information

Please enter the property owner's information below:

Is the property owned by an individual or a business?

First Name

Last Name

Business Name

Property Manager Information

Company

First Name

Last Name

Please enter the mailing address for the property owner or the property manager below:

Street or PO Box

City

State/Province

ZIP/Postal Code

Phone Number

Confirm email

Acknowledgements

I understand that misinformation regarding the service address may result in additional charges and/or interruption of service.

Acknowledgements

I agree to provide further documentation to verify the information supplied above if requested by the Cooperative.

Acknowledgements

I attest that I have reviewed all of the information on this application and verified that it is correct.

Tenant Signature

Tenant's Signature

Tenant Signature

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