Text Box: Date:_________________________ Name:______________________________________________________ CEC Acct #:___________________ Address:_____________________________________________________ City:_________________________ State:__________ Zip:_________ Phone:________________________ Bank Name:____________________ City:_________________________ Bank Acct #:____________________ Please attach a voided check to this application.

It is mutually understood that:

The purpose of this agreement is to provide our creditworthy customers with the opportunity to spread their energy costs over a twelve month period.  The initial payment will be $____________, and a like amount will be drafted from the customer’s account on the 15th of each month. The payment amount is based on an estimate of the customer’s usage and current market prices. Occasional adjustments of this payment may be necessary to cover actual use or market price increases or decreases.  Customer agrees to pay any charges incurred by their usage.  The Customer agrees to notify Consolidated Energy of any change that may increase consumption of fuel.  Consolidated will notify the Customer in writing in the event that a change in the monthly installment amount becomes necessary.  This agreement will continue in effect until 30 days after written notification of either parties desire to terminate is served to the other party.

 

__________________________________________

Account Holder’s Signature

 

Easy as ABC Program Enrollment Application

 

Please mail the completed application to:

 

Consolidated Energy Company

PO Box 317

 Jesup, Ia  50648