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Steuben Rural Electric Cooperative, Inc. |
| Please complete the following: |
| Landlord's Name |
| Billing Name, if different |
| Mailing Address |
| Home Telephone |
| Work Telephone |
| Signature |
| Date |
| Tenants (Please list all adults living at the residence) |
| Service Address |
| Account Number |
| Meter Number |
| What would you like us to do when the tenant vacates the property and requests a disconnect? |
| Please circle one: 1. Return service to your name with no interruption of service. |
| 2. Shut the service off. |
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Mail to: |
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Billing Department |
|
Steuben Rural Electric Cooperative, Inc. |
|
9 Wilson Avenue |
|
Bath, New York 14810 |