Request for Discontinuance of Electric Service

Existing Account

Section 1: Existing Account

Phone Number
more items
Member Service Address

Section 2: Disconnect Request

Are you disconnecting because you are selling?
New Owner / Realtor
For all phone numbers, please use the format, XXX-XXX-XXXX.
Is this a rental unit?
For all phone numbers, please use the format, XXX-XXX-XXXX.
Owner's Address
Mailing Address for Final Bill
I (We) hereby request the electrical service provided to the address listed above by San Miguel Power Association be disconneted.  I (We) understand and agree that I (We) are responsible for electrical usage and the bill thereon until the date of the final meter reading and actual disconnect.  This agreement becomes effective the date it is signed.  By signing below, I (We) certify that I am (We are) authorized to enter into this agreement and agree to hold harmless and indemnify San Miguel Power Association for any damages whatsoever as a result of this agreement.  In case of default, I (We) agree to pay court cost, reasonable attorney's fee, and all collection costs.
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