Sign-Up for Residential Service EmailThis field is for validation purposes and should be left unchanged.Applicant Name(Required) First Last Suffix or Middle NameEmail(Required) Social Security Number(Required)Are you already an active Member with CFEC?(Required) Yes No Have you had service at this location before?(Required) Yes No Account NumberAre you the property owner?(Required) Yes No Please provide proof of ownership(Required)Attach a copy of the warranty deed or settlement statement with the seller's signatures. Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 100 MB, Max. files: 3. Are you leasing or renting the property?(Required) Yes No Please provide a copy of your rental or lease agreement.(Required) Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 100 MB, Max. files: 2. Does your request require a permit? (New construction, Upgrade, RV Pole, Electrical Reconnect, ETC)(Required)Are you building a new facility, placing a new modular home or RV site? Yes No Has your permit been inspected?(Required) Yes No Meter Number(Required)8-12 digit number on the face of the meterFor services that require a new meter to be installed on the property, all property owners must sign an easement agreement. This provides CFEC access to the property to ensure service is maintained during outages, right of way operations and meter audits can be performed during normal working hours. This easement covers 15 feet on either side of the power line or where CFEC equipment is located. After submitting the residential service form, you will receive an email containing the easement document along with instructions for further actions.Building Permit(Required)Permit Number(Required)Parcel NumberName on Permit(Required)Upload Copy of Permit(Required)Max. file size: 100 MB. Physical (911) Address(Required)This is the address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Billing/Mailing Address(Required)This is the address Same as 911 address above Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary Telephone Number(Required)Primary phone is my:(Required) Home Phone Mobile Phone Both Home and Mobile Upload picture of Photo ID(Required)Upload Picture of Photo ID ( License, State Id , Etc) of applicant Max. file size: 100 MB. Authorized ContactThis contact will be able to obtain information regarding the account but will not be authorized to make changes to the account. First Last Alternative Contact Phone Number(Required)Alternative Contact Email(Required) Billing MethodPlease choose a billing method(Required) Standard Account (Billed Monthly) Prepay Account (Billed Daily) Would you like to enroll in paperless billing? (You will receive a 50 cent bill credit once you enroll) Yes No Would you like to sign up for e-bill notifications?YesNoPlease Enter Your Email AddressKeep in mind this is the email your e-bill notifications will be sent to each month. Refundable Membership Fee$5 Non-refundable Connect Fee (If power is currently on)$30 Non-refundable Connect Fee (If power is currently off)$60 Deposit Required for Pay-As-You-Go$50 Intial Credit Balance$30 Refundable Membership Fee$5 Non-refundable Connect Fee (If power is on)$30 Non-refundable Connect Fee (If power is off)$60 Deposit RequiredAssesed on credit risk ($0-$300) Non-refundable new meter service$90 Gate Locks & Gate Code InformationDo you need a gate lock?(Required)If you are installing fence or already have one around the property, CFEC will add one of our locks to your gate. This lock is only used by CFEC employees in the event we need to access the property for equipment maintenance or outage situations. Gate locks can be picked up at one of the CFEC office locations. Yes No Lock Agreement FormDo you have an electric gate? Yes No Name(Required) First Last Account NumberMap NumberGate CodeAddress(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Applicant Electronic Signature (Full Name)(Required) I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Full Name(Required)Date(Required) Month Day Year Sales Tax ExemptionIs this account for residential usage or agricultural usage?(Required) Residential Usage Agricultural Usage Name(Required)Florida States Tax Number (If Applicable)This is to certify that all electric service purchased from Central Florida Electric Cooperative, Inc. on the account number(s) indicated is or was purchased for sure by an organization exempt from Florida Sales and Use Tax under criteria in sections 212.08(5)(e)2, 212.08(6), 212.08(7), or 213.12(2) Florida Statutes (F.S) after [insert date below.]Electronic Signature (Full Name)(Required)Date(Required) Month Day Year If you have further questions, contact: Florida Department of Revenue (800) 352-3671 5050 W Tennessee St, Bldg. F-4 Tallahassee, FL 32399-0100Member Electronic Signature (Full Name)(Required) I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature. The undersigned (hereinafter called the “Applicant”) hereby applies for membership in, and agrees to purchase electric energy from Central Florida Electric Cooperative, Inc. (hereinafter called the “Cooperative”) upon the following terms and conditions:Acknowledgement of Terms 1 of 9(Required)I understand that upon submission of this application by the Cooperative, the Applicant will pay to the Cooperative a $5 membership fee, service security deposit and a non-refundable processing and connection fee. I acknowledge and understand the above text.Acknowledgement of Terms 2 of 9(Required)The Applicant understands that any bad debt balance owed to the Cooperative will be turned over to a collection agency and any cost associated with the collection process will be paid by the applicant. I acknowledge and understand the above text.Acknowledgement of Terms 3 of 9(Required)The Applicant will provide the Cooperative with a valid photo ID. such as a driver’s license or state issued non-driver’s ID along with a valid Social Security Number or Federal Employer Identification Number for non-human applicants and telephone number. I acknowledge and understand the above text.Acknowledgement of Terms 4 of 9(Required)The Applicant will, when electric energy becomes available, purchase from the Cooperative all electric energy used by the provided service. and will pay there for monthly at Board approved rates determined in accordance with the Policies of the Cooperative. I acknowledge and understand the above text.Acknowledgement of Terms 5 of 9(Required)The Applicant will comply with and be bound by the provisions of the Charter, Bylaws and Policies as may from time to time be adopted by the Cooperative. I acknowledge and understand the above text.Acknowledgement of Terms 6 of 9(Required)The Applicant understands the Cooperative supplies the meter at no charge. The meter remains the property of the Cooperative and is not to be purchased from anyone or sold to anyone. I acknowledge and understand the above text.Acknowledgement of Terms 7 of 9(Required)As an approved member, the Applicant assumes no personal liability or responsibility for any debts or liabilities of the Cooperative. The acceptance of the application by the Cooperative shall continue in force until termination by any failure of the member to abide by the provisions set forth in the Bylaws or Policies of the Cooperative, or until canceled by at least thirty (30) days written notice given by either party to the other. I acknowledge and understand the above text.Acknowledgement of Terms 8 of 9(Required)As a condition of membership, the Applicant, upon being requested by the Cooperative, shall execute and deliver to the Cooperative without charge, easements of right-of-way over, on, and under such land owned or leased by or mortgaged to any member, and in accordance with reasonable terms and conditions, and give Cooperative unlimited ingress, egress and access to Applicant’s property as the Cooperative shall require for the furnishing of electric service to such members or other members for the construction, operation, maintenance, or relocation of the Cooperative’s electric facilities. I acknowledge and understand the above text.Acknowledgement of Terms 9 of 9(Required)The Cooperative will endeavor to furnish continuous service but does not guarantee uninterrupted service and is not liable for any damage which the member may sustain by reason of the failure or partial failure of the power, failure or reversal of phases, or variation in service characteristics whether caused by accident, repairs, storms or incurred by the use of any service wiring, connection, instruments, service or appliances installed by or for the member; nor is the Cooperative liable for damages that may be incurred due to the presence of the Cooperative’s property on the member’s premises. In the case of three-phase service required by the member, the installation and maintenance of adequate relays with circuit breakers to protect against single- phase conditions and phase reversal are desirable, and their installation and maintenance is the responsibility of the member. I acknowledge and understand the above text.Full Name(Required)Date(Required) Month Day Year Feel free to use the field below to share any questions or comments you have with our team regarding your electric service application.
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