Service Application

PLEASE SELECT THE PREDOMINANT USE OF ELECTRICITY FOR THIS SERVICE LOCATION:

Applicant certifies that the following is the predominant use of electricity. If energy purchased results in a sales tax liability due to use other than stated, the Applicant assumes responsibility for remitting such tax due directly to the Director, Missouri Department of Revenue.

PLEASE SELECT THE PREDOMINANT USE OF ELECTRICITY FOR THIS SERVICE LOCATION:
Residential

Primary Applicant Information

full name
Primary Applicant Information

Co-Applicant Information

co applicant name
Physical Address of Service

Different Mailing Address

Mailing Address
Landlord Name
A monthly rental fee applies for security light service.
Connect date will be confirmed once application is processed.

Roundup Foundation

Agreements / Bylaws

Thank you for your request.

 After receiving confirmation, you should expect a call within one business day to schedule your connection. If you do not receive a call, please contact our office directly. Please note that connections are only performed during business hours.

Agricultural/Commercial/Other
Is this account exempt from Missouri state and local sales tax?
If you answered Yes above, a valid Missouri Sales Tax Exemption Certificate (https://dor.mo.gov/forms/149.pdf) must be provided before the account can be established as tax-exempt. Tax will be charged until a valid certificate is on file. The Missouri Sales Tax Exemption Certificate may be uploaded here or emailed to info1@wcecoop.com.
One file only.
20 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, svg.

Primary Applicant Name

Primary Applicant Name
Is this a business account?
Authorized Contact Person (if different from applicant)
Would you like to add a co-applicant to the account?

Co-Applicant Information

co_ap_name_ag
Physical Address of Service
Will your mailing address be different from the physical address of service?
Mailing Address
A monthly rental fee applies for security light service.
Connect date will be confirmed once application is processed.

Roundup Foundation

Agreements/Bylaws

Thank you for your request.

 After receiving confirmation, you should expect a call within one business day to schedule your connection. If you do not receive a call, please contact our office directly. Please note that connections are only performed during business hours.