Paper Ballot Opt-Out Request

Applicant Information

First Name

Last Name

Account Number

This can be found on the upper right of your bill or by logging into your online account.

Confirm Paper Ballot Opt- Out

I plan to vote electronically, and would like to opt out of receiving a mailed paper ballot.

Service Address

Physical address where you receive electrical service from Flathead Electric Co-op.

Street Address

Address Line 2

City

State Abbreviation

Zip Code

Phone

Confirm the email address associated with your online account where your ballot will be emailed.

If you do not have an online account, you can create one here.

Authorization

Authorized Account Holder Digital Signature (Full Name)

Digital Signature Authorization

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 form will be stamped with today's date and authorized by me as if I had signed my signature.

Salesforce Required Fields

Record Type Name