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Automatic Reinstatement

The undersigned, as owner hereby authorizes Mountain View Electric Association, Inc. (MVEA) to take the following action during periods of vacancy at the address and account number listed below.

Account Number(Required)

Service Address(Required)

Street Address Address Line 2 City State ZIP Code

Property Owner Information - Must be kept current for Capital Credits Retirement Distribution

Property Owner Name(Required)

The property owner's name must be the same as the signed application.

First Last

Is This a Joint Membership?(Required)

Yes

No

Co-Owner Name(Required)

First Last

Property Owner Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Property Owner Email(Required)

Property Owner Primary Phone Number(Required)

Is the Property Owner Primary Phone Number a Mobile Phone Number?(Required)

Yes

No

Property Owner Mobile Phone Number(Required)

If the primary phone number is not a mobile number, please provide a mobile number.

Please select one of the choices below. Please be aware that a deposit may be required. You will be responsible for all electric charges and fees while the service is in your name.(Required)

Leave service on and bill the owner information above.

Remove current owner information. The property has been sold.

Leave service on and send bill to authorized agent/property management company.

Shut off service – do not bill (unless winterized, prolonged periods of sub-freezing temperatures may result in broken water pipes and other damage. MVEA is not responsible for any loss or damages).

Authorized Agent or Property Management Company Name(Required)

Authorized Agent or Property Management Company Address(Required)

Street Address Address Line 2 City State ZIP Code

Authorized Agent or Property Management Company Phone(Required)

Authorized Agent or Property Management Company Email(Required)

Consent(Required)

Important Exclusion: Automatic Reinstatement will only apply if the tenant’s account with MVEA is current. If the tenant is delinquent in payment for electric service, MVEA’s policies will apply and service may be disconnected. MVEA offers a Third-Party Notification. With the tenant’s written consent, you can be notified if a delinquent notice has been mailed to the tenant. Please contact MVEA for details.

This information will be made a permanent part of our records. It will be necessary for you to advise us if the property is sold so we can update our records. Without MVEA being notified in writing of sale and transfer of ownership, service could be placed into the former owner’s name, resulting in additional charges. A new form must be submitted if you make any changes to this information. No guarantee is made that service will not be disconnected upon a renter’s request except that MVEA will make every effort to grant requests for automatic reinstatement.

I agree to the terms and conditions.

Are you the property owner or an authorized agent?(Required)

If the authorized agent signs this form, a copy of the property management agreement with the owner must be attached.

Property Owner

Authorized Agent

Property Owner Signature(Required)

Authorized Agent Signature(Required)

Signature Date(Required)

MM slash DD slash YYYY

Co-Owner Signature(Required)

Co-Owner Signature Date(Required)

MM slash DD slash YYYY

Property Management Agreement File Upload(Required)

Max. file size: 100 MB.

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OFFICE LOCATIONS

Toll-Free: (800) 388-9881
Automated Pay by Phone: (877) 999-3415
Monday through Thursday 7 am to 5:30 pm

FALCON

11140 E. Woodmen Road

Falcon, CO 80831-8127

Phone: (719) 495-2283

Fax: (719) 495-3014

Directions to Falcon
LIMON

1655 5th Street

PO Box 1600

Limon, CO 80828-1600

Phone: (719) 775-2861

Fax: (719) 775-9513

Directions to Limon

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