Muscle Shoals Electric Board, AL - Commercial Application for Service

Business Name:
Applicant's Name: Applicant's Name: First Last
Email
Service Address: Service Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Mailing Address: Mailing Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Do You Own This Business?

Do You Own This Business? Yes No If not, who does? If not, who does?
Do You Own This Building?

Do You Own This Building? Yes No If not, who are you renting from? If not, who are you renting from?
Business Phone: Business Phone: - ### - ### ####
Corporate Office Phone Number: Corporate Office Phone Number: - ### - ### ####
Home Phone: Home Phone: - ### - ### ####
Have you ever had service with Muscle Shoals Electric Board?

Have you ever had service with Muscle Shoals Electric Board? Yes No
If the answer to the previous question is yes, at what address ? If the answer to the previous question is yes, at what address ?
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Requested Date for Turn On: Requested Date for Turn On: / MM / DD YYYY
Copy of MSEB Service Agreement For Your Records
Agreement:

Agreement: I fully understand that five (5) days after penalty date, that this service will be discontinued without further notice if bill is not paid in full. I fully understand that this business will be responsible for the charges incurred at this address until a representative of this business signs an order or notifies MSEB in writing, to discontinue service. I agree to permit authorized agents of MSEB free access to the premises of the consumer for the purpose of reading, repairing, or removing property of MSEB. I agree that this application is subject to MSEB’s Rules and Regulations, a copy of which is open for inspection at the office of MSEB, and these Rules and Regulations are a part of this agreement. I agree that I have been informed about where I may obtain copies of MSEB Rules and Regulations and the Rate Information. I agree that if this business is in default and the account is referred to an attorney or collection agency, this business and/or owner will pay all reasonable collection fees, attorney fees, and court or other costs as permitted by law and as actually incurred by MSEB. If at any time I provide a wireless telephone number at which I may be contacted, I consent to receive calls (including autodialed calls and prerecorded messages) at that wireless number from MSEB, and its successors and assigns, and the affiliates, agents, and independent contractors, including servicers and collection agents, of each of them regarding my account, the services rendered, or my related financial obligations. I certify that the above information is true and that I have received a copy of this document from Muscle Shoals Electric Board.
Representative's Driver's License:
Maximum of 9 characters allowed. Currently Entered: 0 characters.
Attach Driver's License:
Social Security Number:
Maximum of 9 characters allowed. Currently Entered: 0 characters.
Corporate Federal Tax ID#:
Maximum of 15 digits allowed. Currently Entered: 0 digits.
Other:
Maximum of 15 digits allowed. Currently Entered: 0 digits.
Customer Legal Signature: (Please draw your signature into the box below)

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Official Capacity:
Maximum of 15 characters allowed. Currently Entered: 0 characters.
Thank you for Applying for Service with MSEB

Next you will receive an email from one of our customer service representatives during regular business hours, Mon-Fri, with further instructions to complete the application process. Please watch for this email and follow the instructions carefully. Connection fees and deposits for service will be required. APPLICATIONS RECEIVED AFTER 4:00 P.M. WILL NOT BE PROCESSED UNTIL THE NEXT BUSINESS DAY.

Muscle Shoals Electric Board, AL - Commercial Application for Service

Copy of MSEB Service Agreement For Your Records

Thank you for Applying for Service with MSEB