Please read the Rules of PrePay Service (PDF) before completing the form. Name(Required) First Last Address(Required) Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Account Number(Required) Email(Required) Mobile Phone(Required)Mobile Provider(Required)Home PhoneFor contact on the "Balance Notification Service" I would prefer:(Required) Email messages only Text messages only Both email and text messages Applicant Consent(Required) I have read the Rules of PrePay Service (PDF). I hereby verify the above information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.I understand the Prepaid Electric Service Terms and hereby elect to receive electric service under the “PrePay” option offered by Northeast Power (Northeast). I understand that in electing the PrePay option that I am also subject to all Northeast bylaws, rules and regulations, policies, and tariffs unless otherwise specified in the Prepaid Electric Service Terms. I also understand that it is my responsibility to monitor my account and to maintain a credit balance in order to receive uninterrupted service. I accept responsibility for any consequences, including personal injury or property damage, which might result from my failure to make timely purchases of electricity in order to maintain uninterrupted electrical service. I understand that Northeast does a Balance Notification Service to its PrePay customers. It is my responsibility to maintain, and keep Northeast informed of an available means of communication. I will be responsible for any voice, data, or text messaging costs incurred. I acknowledge that notifications may not be received for a variety of reasons and that there is no guarantee that timely notifications will be received. I acknowledge that I am responsible for maintaining a credit account balance whether or not timely notifications are received and hold Northeast Power harmless from any liability for injuries or damages that might result from failure to receive timely notifications. Note: If the Prepaid account is subject to collections because a credit balance was not maintained, the balance owing, plus all collection fees, plus the full balance still owing for any special arrangement, plus a minimum starting credit balance must be paid before the service would be reconnected. 1) The District will make personal phone calls to avoid scheduling a collection, and each call will be charged to the customer at a rate of $5 per call.Applicant Electronic Signature (Full Name)(Required) If a debt management pay arrangement has been made to start Prepay, 40% of each payment made toward the prepaid account will be applied to the initial debt management payment arrangement amount until the debt management payment arrangement balance is paid in full.