Annual True-Up Open Enrollment Form Member Name(Required) First Last Email(Required) Service Address(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 Is the Service Address the Same as the Mailing Address?(Required) Yes No Mailing Address(If different than 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 I understand that I can only change from Option 2 - Indefinite Rollover to the Option 1 - Annual True-Up between January 1 and January 31.(Required) By checking this box I understand that I am agreeing to the above statement. My election for Option 1 - Annual True-Up will be effective as of January 2026.(Required) By checking this box I understand that I am agreeing to the above statement. I understand that my account will only be credited any remaining unused balance of kWh up to a maximum of three thousand (3,000) kWh.(Required) By checking this box I understand that I am agreeing to the above statement. Today's Date (MM/DD/YYYY)(Required) Month Day Year Member Signature(Required)By typing your name in this field, you are stating that you understand and agree to the terms listed on this form. CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.