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.

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.

Appropriate fees must be paid before service will be connected. A cooperative representative will be contacting you for payment.

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.