Transfer or Stop Service Request

Member Information (as it appears on your monthly statement)

First Name

Last Name

Phone Number

Account Number

Current Service Information

Street Address

City

State

Zip Code

Do you own or rent this property?

OwnRent

Landlord Name

Landlord Phone Number

General Information

Date Service to be Transferred or Stopped

Is service being transferred to a new location within Flathead Electric's service territory, or are you stopping service due to moving out of our territory?

Transferred to a New Address within Flathead Electric Service TerritoryStopped Due to Moving out of Flathead Electric Service Territory

Fee Explanation

Existing members are subject to a $15 transfer fee to transfer service to a new location within Flathead Electric's service territory.

All new members are subject to a $30 new member fee.

Applicable fees will be added to your next electric bill.

New Service Location Information

Date Service to Start at New Location (if different from stop date at old address)

New Service Address

Street Address

City

State

Zip Code

Do you own or rent this property?

OwnRent

Landlord Name

Landlord Phone Number

New Contact Information

Forwarding Address (where we still send your final bill and future capital credit checks)

Mailing Address

City

State

Zip Code

Authorization

Signature

Authorization Required

I herby verify the above information to be true and complete. I understand that by typing my full name above and pressing the Submit button below, this application will be stamped with today's date and authorized by me as if I had signed my Signature.

Salesforce Required Fields

Program ID

Record Type Name

FEC Form Owner Email