WP E-Signature by Approve Me - Sign Documents Using WordPress -

Budget Billing Agreement

SUWANNEE VALLEY ELECTRIC COOPERATIVE INC

PO BOX 160 LIVE OAK FL 32064

BUDGET BILLING AGREEMENT

Member Name _______________________________

Account #_________________________________

I, the undersigned member, request a budget billing program for the above account. I understand that my account must qualify as outlined below:

My electric service must be strictly residential usage.
My account must have been active for at least the most recent 12 months, with no record of service disconnection due to non-payment, and, with no record of a check having been returned unpaid by my bank.
My account balance must be zero to enter the program.
The monthly budgeted payment must be received by the SVEC office on or before the delinquent date printed on the bill. If the total amount of the monthly budgeted payment is not received by the next billing date, my account will be automatically placed back on a regular billing schedule, without notification, and any previous balance becomes due immediately. Further, my account must remain off the Budget Billing Program for the next 12 months.
If my electric service is terminated by me or by SVEC, for any reason, the entire outstanding balance becomes due within ten days.

The monthly budget billing payment is calculated each month by averaging the previous twelve months’ bills. The budget billing payment amount is printed on the electric bill.

Member Signature: _________________________________________ Accepted by:_______________

Date Signed:______________ Date:_____________________

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

2017-04-13 11:50:44 EDT

Budget Billing Agreement Uploaded by John Robinson - johnr@svec-coop.com IP 174.212.0.170, 127.0.0.1, 198.71.243.21, 0.0.0.0