Account Access Authorization

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Authorized Account Designee

Authorized Designee password to access account

Check One

I grant the above authorized designee limited access to obtain payment and billing history, make payments and reconnect accounts disconnected for non-payment. The authorized designee does not have the authority to connect or disconnect service, make payment arrangements or access the member’s personal information. The authorized designee is not responsible for the debt on the account nor have any claim to capital credits. I revoke access to my electric account(s) for the above authorized designee. 

Accounts included in this authorization

All accounts currently in my name and any future accounts.Specified account number(s) only.  

Account Number(s)

Member Name

Date

Customer #

SSN

Phone #

Email