Third Party Notification | South Central Arkansas Electric Cooperative

A residential customer may designate a consenting person/agency to receive a copy of any disconnect notice issued. Upon written notification, the utility shall mail an additional copy of a disconnect notice to the designated person/agency.

Third Party Notification

Full Name

Service Address

City/Town

State/Province

ZIP/Postal Code

Billing Address

City/Town

State/Province

ZIP/Postal Code

Account Number

Telephone Number

Person or Agency that may be contacted prior to termination

Name

Address

City/Town

State/Province

ZIP/Postal Code

Telephone Number

checkbox

I understand the form below authorizes South Central Arkansas Electric Cooperative to provide information regarding my account to the person/agency designated below. I have read and understand the information on this form.

signature

Sign above

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.