Step 1 of 3 33% InstagramThis field is for validation purposes and should be left unchanged.Type of Service(Required)Please SelectStandard AccountPrepay Account Prepay AgreementThe undersigned (herein called the “Member”) hereby applies for participation in the PRE-PAY METERING PROGRAM offered to Members of South Central Arkansas Electric Cooperative, Inc. (hereafter called the “Cooperative”), and agrees with the Cooperative to the following terms and conditions (Initial after each of the following statements):Prepay Agreement #1(Required) It is the Member’s responsibility to manage their own communication devices. All communication device charges and fees related to the notifications received from the Cooperative are also the responsibility of the Member.(Required)Prepay Agreement #2(Required) If the Member changes any of the contact information (i.e., email address, phone number, etc.) provided on this agreement, it is the responsibility of the Member to notify the Cooperative of any such changes immediately.(Required)Prepay Agreement #3(Required) The Member understands that he/she will not receive monthly billing statements or Shut Off Notices. Instead, the member will receive notifications via each communication method indicated above. It is advisable the PRE-PAY METERING PROGRAM Member maintain at least one method for notifications to be received. All members wishing to do so will be notified when their PRE-PAY METERING PROGRAM account drops to a default level of $10.00 credit balance.(Required)Prepay Agreement #4(Required) The Member understands that he/she can monitor his/her usage history, daily average rate of energy usage, available credit, balance, etc. via computer and the SmartHub link or via a smartphone and the SmartHub App.(Required)Prepay Agreement #5(Required) The Member shall purchase electric service from the Cooperative in accordance with the present and any future rate schedule of the Cooperative on a PRE-PAY METERING PROGRAM basis for the below referenced account. Prepaid accounts are sometimes being based on estimated amounts (ie: weekends and holidays). All prepaid accounts will be brought to a true and accurate usage amount on a monthly basis.(Required)Prepay Agreement #6(Required) Pursuant the Arkansas Public Service Commission rules, the Member shall pay any connect and/or other applicable fees and charges assigned by the Cooperative as may be required to participate in the PRE-PAY METERING PROGRAM.(Required)Prepay Agreement #7(Required) Any security deposit previously paid by the member to the Cooperative will be applied in full to the Member’s outstanding balance at the commencement of participation in the PRE-PAY METERING PROGRAM, and any credit remaining may be applied to the Member’s PRE-PAY METERING PROGRAM account balance. A minimum credit balance of $20.00 will be required to launch an PRE-PAY METERING PROGRAM account.(Required)Prepay Agreement #8(Required) If a Member’s security deposit, once fully applied, does not cover the outstanding balance owed, including the unbilled usage amount, the remaining amount owed can be initially set up for “payment arrangements”. This initial “delinquent balance” will be paid on a 50/50 basis. The Member will need to factor in 50% of any future payments going toward this delinquent amount.(Required)Prepay Agreement #9(Required) The Cooperative is not a banking institution. Under no circumstances will a refund be issued for a credit balance on a PRE-PAY METERING PROGRAM account while in the PRE-PAY METERING PROGRAM.(Required)Prepay Agreement #10(Required) The Member shall be responsible to regularly monitor the balance on the PRE-PAY METERING PROGRAM account and understands that electric service will be subject to disconnection without any notification from the Cooperative to the Member once the balance of the account reaches zero ($0.00).(Required)Prepay Agreement #11(Required) Any return payment fees (NSFs) and/or other applicable charges (for meter tampering, etc.) must be paid in full prior to reconnection and before any amounts are applied to the non-fee balance of the PRE-PAY METERING PROGRAM account.(Required)Prepay Agreement #12(Required) PRE-PAY METERING PROGRAM accounts shall not be eligible for “Extensions” with the Cooperative and energy assistance shall not be applied in full until actually received as payment on the member’s PRE-PAY METERING PROGRAM account.(Required)Prepay Agreement #13(Required) If a Member requests to disconnect service, the member shall be refunded any credit balance on the PREPAY METERING PROGRAM account following final billing when the account is brought up to date with accurate usage amounts(Required)Prepay Agreement #14(Required) If a PRE-PAY METERING PROGRAM account is disconnected for non-Payment then the service will be reconnected only after funds have been received.(Required)Prepay Agreement #15(Required) If a PRE-PAY METERING PROGRAM account is disconnected for non-payment for more than 7 business days the PRE-PAY METERING PROGRAM account will be closed and made inactive. This helps the Member by limiting the number of days of prorated Service Availability charged to the PRE-PAY METERING PROGRAM Member.(Required)Prepay Agreement #16(Required) The Cooperative shall be held harmless from any damages due to loss of energy services, or during the reconnection of service, as a result of the member’s participating in the PRE-PAY METERING PROGRAM. When a Member pays to reconnect service the Member assumes all responsibility for the safe condition of his/her home upon self-activated reconnection.(Required)Prepay Agreement #17(Required) I understand that my payment options include: 1 ) by mail once received in the office, 2) in person at the Cooperative’s offices during business hours, 3) by computer and SmartHub link using a credit/ debit card or e-check on South Central Arkansas Electric Cooperative, Inc. website at scaec.com, 4) by smartphone and SmartHub app using a credit/debit card or e-check, or 5) by phone using a credit/debit card or e-check by calling our toll free phone number (800) 814-2931. A Convenience Fee of $4.00 will be charged for each transaction.(Required)Prepay Agreement #18(Required) South Central Arkansas Electric Cooperative, Inc. reserves the right to modify the service rules and regulations, pursuant the Arkansas Public Service Commission, at any time without prior notification of the Member.(Required)Prepay Agreement #19(Required) The Cooperative reserves the right to remove any member from PRE-PAY METERING PROGRAM at any time, without consent or notification.(Required)Unable to continue until all boxes are checked. Applicant InformationType of Account Individual Legal entity Trust General partnership Limited partnership Estate Unincorporated association Government body Organization NameApplicant Full Name(Required) First Middle Initial Last List of full legal names of all general partnersClick (+) to list additional names Add RemoveSocial Security Number(Required)ID Number - DL, State ID, Military ID, Passport, or I-551Upload Image of IDAccepted file types: jpg, gif, png, pdf, Max. file size: 500 MB. Upload Legal Documentation Drop files here or Select files Max. file size: 5 MB. Date of BirthMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Applicant's Place of Employment(Required)Email(Required) Primary Phone(Required)Do you have a co-applicant?(Required) Yes No Co-Applicant's Name(Required) First Middle Initial Last Co-Applicant's Social Security Number(Required)Co-Applicant's ID Number - Driver’s License, State ID, Military ID, Passport, or I-551(Required)Upload Image of Co-Applicant's ID(Required)Accepted file types: jpg, gif, png, pdf, Max. file size: 4 MB. Co-Applicant's Date of Birth(Required) Month Day Year Date Service Requested (mm/dd/yyyy)(Required) Month Day Year Own or Rent(Required) Own Rent Landlord's NameLandlord's PhoneUpload a signed copy of your rental agreement.Accepted file types: jpg, gif, png, pdf, Max. file size: 4 MB. Previous Address 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 Billing 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 New Service Address(Required) Same as previous 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 Has there ever been electric service at this location? Yes No Do you currently have active service with South Central Arkansas Electric Cooperative, Inc.? Yes No Please list your active account number(s)Please click (+) to list additional account numbers. Add RemoveWill the above referenced account(s) need to be disconnected? Yes No Other Date of DisconnectionMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Type of ServiceList all that apply Home Barn Shop Security light Boat slip New loop meter Seasonal Campsite Other Please specifyCheck the box(es) if you wish your account to be registered for Age 65 or Older Handicapped (Doctor’s certification required – certification from a physician, licensed psychologist, by the United States Veteran’s Administration, the Social Security Administration, the Arkansas Department of Human Services, the Arkansas State Hospital, or a licensed mental health center.) If there is a SECURITY LIGHT at this location, would you like to keep it? Yes, I choose to keep the security light(s) that are currently connected at my new service location and agree to pay the associated monthly service fee(s). No, I choose to disconnect the security light(s) that are currently connected at my new service location and do not want to pay the associated monthly service fee(s). I would like to inquire about having a security light installed at my new service location and agree to the associated monthly service fee(s). Member ConsentMember Consent #1(Required) The applicant, whose name appears below, is applying to the South Central Arkansas Electric Cooperative, Inc., of Arkadelphia, Arkansas for electric service to be supplied, at a nominal voltage of 120/240 volts, at the location herein described and, upon request, at any other location to which he or she may move within the area served by the Cooperative.(Required)Member Consent #2(Required) The applicant agrees to pay for said service as bills are due in accordance with the bylaws and policies as provided by the board of directors of the Cooperative and further agrees to comply with rates, rules and regulations approved by the Arkansas Public Service Commission as they now exist or as may hereafter be adopted and in effect at the time of delivery.(Required)Member Consent #3(Required) Appropriate fees must be paid before service will be connected. A cooperative representative will be contacting you for payment.(Required)Member Consent #4(Required) The applicant further agrees to release and discharge said cooperative from any liability for damages suffered by reason of interruption, discontinuance or disconnection of service hereunder from any cause, or by reason of the maintenance, location or existence of any of the facilities, fixtures or systems located on or adjoining the property supplied and by which such services are furnished or delivered.(Required)Member Electronic Signature (Full Name)(Required)Member Electronic Signature (Full Name)(Required)Please select an identity question(Required)Please SelectCity of Birth?Mother's Middle Name?Father's Middle Name?Please answer the security question(Required)CAPTCHAUnable to submit until all boxes are Member Consent checked.