Commercial & Industrial Application

Step 1 of 2

Business Name(Required)

Is this application for a partnership, corporation, or sole owner?(Required)

Partnership

Corporation

Sole Owner

Service Address(Required)

Street Address Address Line 2 City State ZIP Code

Is the mailing address the same as the service address that is listed above?(Required)

Yes

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Federal Tax ID Number(Required)

If you do not have a Federal Tax ID number, enter your SS number or N/A.

Business Phone(Required)

Sales Tax Exempt Number

Sales Tax Exempt Date (mm/dd/yyyy)

File

Attach a signed copy.

Drop files here or

Max. file size: 300 MB.

Name of Owner(s)(Required)

First

Last

Job Title

Phone(Required)

Date of Birth (mm/dd/yyyy)(Required)

Social Security Number(Required)

Driver's License(Required)

State(Required)

State

Contact Person(Required)

First Last

Job Title

Contact Person Email(Required)

Phone(Required)

Photo ID

Business Owner | Contact Person

Max. file size: 300 MB.

Certificate of Membership

I, (hereinafter called "applicant") hereby apply for membership in and agree to purchase electric energy from Appalachian Electric Cooperative, Jefferson City, Tennessee, (hereinafter call "Cooperative") to be supplied at any address served by said Cooperative.

The applicant agrees to pay for said services as bills are rendered therefore, in accordance with the By-Laws of the Cooperative. Rules and Regulations as may be adopted from time to time by the Cooperative, and rates in effect at the time of the delivery of service.
The applicant agrees, when electric service becomes available, that all electric energy used on the premises will be purchased from the Cooperative and will be paid for at rates currently in effect or as amended from time to time provided, however, that the Cooperative may limit the consumption of electric energy which it shall be required to furnish the applicant.
The applicant agrees that a bill of the amount listed below will be paid regardless of the number of kilowatt hours consumed and that this instrument must be considered as a agreement when this section is completed.

The applicant agrees to (a) make payment of such membership fee as required by the Cooperative By-Laws, their amendments, and/or Rules and Regulations in respect to said membership; (b) make such deposits with the Cooperative as may be required by the Cooperative's Rules and Regulations. The acceptance of this application by the Cooperative shall constitute an agreement between the applicant and Cooperative and the contract for electric service shall continue in force until cancelled by either party in accordance with the By-Laws and Rules and Regulations of the Cooperative. The applicant, by becoming a member, assumes no personal liability or responsibility for debts or liabilities of Cooperative and it is expressly understood that, under law, his private property cannot be attached for any such debts or liabilities

Bill amount per month:

Agreement Year

Applicant's Electronic Signature (Full Name)(Required)

All information submitted in this form has AES-256 encryption to protect your personal information.

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

This field is for validation purposes and should be left unchanged.

Commercial & Industrial Application

Certificate of Membership

Physical Address

Mailing Address

Phone Numbers

Quick Links