Request for Payment Arrangement

MVEC realizes challenging times means working with our members so they can comfortably pay for essential items, such as their power bills. This form starts the discussion for making arrangements to bring your account up to date. Please fill it out as completely and accurately as possible. If you are attempting to set up payment arrangements and have received a disconnect notice, this form must be submitted five business days before the due date shown on the disconnect notice.

MVEC will allow payment arrangements to members who have had service with MVEC for at least two months unless any of the following applies:

Three broken arrangements within six months. Member can be re-eligible after 12 months.
Two or more returned bank items within six months.
Two or more DQ notices within six months.
Two or more disconnections within six months.

MVEC will follow the 216b.097 MN Statue for Cooperatives and Municipals from October 1 to April 30 regarding payment arrangements. No payment arrangements will count against members who have commitments for EAP agencies during this time.

Name on MVEC electric bill

First Name

Last Name

MVEC Account Number

Phone Number

My phone number is a

Service Address

Address Line 1

Address Line 2

City

State

Zip Code

Payment Information

Current Balance Due on Account $

Recommended Payment Amount $

What date can the recommended payment amount be made?

How often can you make your recommended payment? (If recommended payment is not enough to cover past due amount.)

Please note that any current bills are due in addition to this arrangement.

MVEC will contact you via phone to confirm this arrangement and to discuss individually tailored installments and other various payment programs to help bring your account up to date.

Your signature below indicates you understand this request is pending until you are contacted by an MVEC Member Account Support Representative, and an agreement has been agreed upon. Once accepted, you will receive a Payment Arrangement Letter to sign and return. When MVEC receives the signed agreement, it will then be processed into our system.

If you do not make the payments as determined in the payment arrangement agreement, we have the option to disconnect your service for non-payment. We disconnect service only as a last resort and would like to avoid having to take this step.

Date

Contact Information