Connecting Service

If you are a new member moving into an existing service please contact our office as soon as possible. Services will be connected the following business day once all the necessary information is received in our office.

Fill Out Membership Record And Application For Member

Membership Record And Application For Member

Member Information

Member Name

First Name

Middle Name

Last Name

Please enter your first, middle and last name.

Business Name

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Please enter your mailing address.

Primary Telephone

Primary Telephone Number

May We Contact You Via Text Message

May we contact you via text message

Secondary Telephone

May We Contact You Via Text Message

May we contact you via text message

EIN or last 4 digits of SSN#

Last 4 Digits Only

Driver's License#

Date of Birth

Email Address

Nearest Relative Name & Phone#

Joint Membership

Yes

Joint Applicant

Other Responsible Party

First

Middle

Last

Relationship

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Please enter your mailing address.

Primary Telephone

Primary Telephone Number

May We Contact You Via Text Message

May we contact you via text message

Secondary Telephone

May We Contact You Via Text Message

May we contact you via text message

Last 4 digits of SSN#

Last 4 Digits Only

Driver's License#

Date of Birth

Service Information

Property Owner Name

Service Address

Service Description

ie: residence-cabin or camper-seasonal home-grain bin-barn or machine shed-electric fencer-livestock waterer-hog building-dairy farm

Legal Agreement

MEMBERSHIP APPLICATION: IN CONSIDERATION OF THE MUTUAL PROMISES SET FORTH IN THE AGREEMENT, COOPERATIVE AND MEMBER HEREBY AGREES AS FOLLOWS:
1. The Cooperative agrees to furnish to the Member in accord with the Cooperative’s rules and regulations, and the Member agrees to purchase from
the Cooperative and pay for all electric energy provided by the Cooperative at the location indicated above as the “service address”. Member agrees to pay the Cooperative monthly for such electric energy pursuant to such rates, terms, rules and regulations as may be established by the Cooperative Rate Schedule and applied to the Member’s location identified above.
2. All service lines supplying member with electric energy, and all meters, switches and other appliances and equipment constructed or installed by the Cooperative in, over, or under the property of the Member shall have the right of ingress and egress to Member’s property for the purpose of constructing, operating and maintaining the Cooperative’s lines and equipment, including the right to cut, trim or remove trees, shrubbery, or other obstacles necessary to operate and protect the Cooperative’s lines and facilities. Member agrees to provide Cooperative access to all meter(s) on the property. Member must not enclose meter(s) or block access to meter(s) with buildings, shrubbery, vehicles, fences or other obstacles that would prohibit the Cooperative accessing the meter(s).
3. Member grants and conveys easement rights and authority to enter in, on and through their land and erect necessary facilities in order to furnish electric service to another member.
4. The Cooperative shall use reasonable diligence to provide a constant and uninterrupted supply of electric energy to Member, but if such supply shall fail or be interrupted, or become defective through act of God, or the public enemy, or by accident, strikes, labor troubles, or by action of the elements, or inability to secure rights-of-way, or other permits needed, or for any other cause beyond the reasonable control of the Cooperative, the Cooperative shall not be liable therefore.
5. The Cooperative has permission and authority to inquire into an applicant’s credit based on the information supplied by the prospective new member. Member agrees to pay a deposit to the Cooperative to secure payment for electric energy to be provided by the Cooperative, pursuant to the Cooperative’s tariff, upon the Cooperative’s request. In the event Member is required to pay an account deposit, the account will be reviewed annually, and the deposit will be refunded if there are no more than 2 late payments in the last 12 months.
6. By selecting “Yes” to be contacted by text messaging or e-mail above, Member grants authority and permission to the Cooperative to provide member notification and communication by sending text messages or e-mails. Additional methods of contact may also include using pre-recorded or artificial voice messages and/or use of an automatic dialing device as applicable.
7. Member agrees to comply with and be bound by the Cooperative’s Articles of Incorporation, Bylaws, rules and regulations.
8. All wiring installed or modified on the Member’s premises at the location identified above shall conform to the requirements of the National Electric
Code wiring specifications, and any future additions, modifications or alterations to said wiring shall conform to said requirements.
9. Member shall allow the Cooperative to engage in reasonable and customary vegetation management activities, including tree trimming, tree removal, brush removal, mowing, and herbicide applications on all properties, whether public or private, without regard to the existence of easements or right-of-ways, wherein the sole judgment of the Cooperative trees, brush, or vegetation interfere with the safe and reliable delivery of
power, energy and telecommunication services or may reasonably be deemed to pose an interference at some future time.
10. In accordance with Iowa Code 476.6A the owner of any alternate energy production facility (solar, wind, etc.) that is attached to the Cooperative lines is required to provide written notification to the Cooperative of the intent to install the facility at least 30 days prior to construction. (The notification form is available on our website at www.sie.coop.) The appropriate Interconnection Agreement must also be completed and signed by the Member and the Cooperative before installation on Cooperative lines occurs.
11. The Cooperative shall have the right, but not the obligation, to inspect all wiring on Member’s premises at any time. In the event such inspection indicates that wiring is not in accord with the Cooperative’s requirements, Member shall make all necessary changes within a period of time specified by the Cooperative. The Cooperative shall have the right to immediately disconnect service to the location in the event it determines that hazardous conditions exist.
12. Member hereby releases and holds the Cooperative harmless from any and all liability of every kind and nature for damage to property or injury or death to persons or animals which may result from defective wiring on Member’s premises.
13. Member agrees to provide updated contact information to the Cooperative within 30 days of changes to said information.
14. If this Membership Application form is submitted to Southern Iowa Electric Cooperative electronically, you agree that all governing documents of the cooperative, including its Articles of Incorporation, Bylaws, rules and regulations, as are applicable to the cooperative membership and as may be adopted from time to time, are available in part on the cooperative’s website, and, in full at its headquarters office in Bloomfield, Iowa and have been, or will at Applicant’s request, be furnished or made available to the Applicant. The same are furthermore incorporated into this Application,
    and Applicant agrees to comply with and be bound thereunder, to the same effect as though fully set forth herein.
15. Privacy Policy
Our Commitment to Privacy
At Southern Iowa Electric Cooperative, Inc. (SIEC), member confidentiality is very important to us. As we continue to improve our services and provide you with all available information concerning your energy use, outage response and account status, we recognize the necessity to preserve member privacy and confidentiality. SIEC is committed to safeguarding the privacy of our members’ information.
The Information We Collect
We receive and retain information about our members through many sources:
 Information we receive on applications or other forms;
 Information about previous transactions with us;
 Information we receive from a consumer-reporting agency;
 Information from meters communicating energy times of consumption and quantities.
The Way We Use Information
We limit the use and collection of non-public member information to that which is necessary to maintain and administer the operations of SIEC. We do not share this information with outside parties unless:
 The information is provided to help complete a member initiated transaction (e.g. credit reporting agencies etc.);
 The member has requested it (subject to verification);
 The disclosure is required by law (e.g. subpoena, investigation of fraudulent activity, etc.); or
 The disclosure is required by banking regulation (e.g. Fair Lending Reporting Act, Home Mortgage Disclosure Act).
When member information is provided to any of the third parties mentioned above, that third party must agree to adhere to privacy principles and standards that provide for keeping such information confidential.
Energy use data/information is available and provided to each member individually through a secured internet connection accessed from the SIEC web page to our E-Business page. Members may use this information as a basis for energy use decisions and to understand the financial impact of their individual choices. SIEC uses this information in the same way as each member which is to understand the electric use of the entire system. This allows the Cooperative to design rates that recover the cost of supplying electricity in the same manner they are incurred. Meter information is also used to measure system performance and for engineering purposes. Member energy use data is retained in a secure location that insures, to the degree reasonable possible, confidentiality and accuracy.
Limiting Employee Access To Information
SIEC limits employee access to member information to those with a business reason for knowing such information. All of our employees are educated on the importance of confidentiality and member privacy. Any employee that compromises member access to information, privacy, and/or data security will be subject to appropriate disciplinary measures and possible termination.
Protection of Information via Established Security Procedures
To prevent unauthorized access, maintain data accuracy, and ensure the correct use of information, we have put in place appropriate physical, electronic, and managerial procedures to safeguard and secure member information.
Maintaining Accurate Information
We have established procedures so that our members’ information is accurate, current and complete in accordance with reasonable commercial and industry standards. SIEC will respond to requests to update or correct inaccurate information in a timely manner.
At Southern Iowa Electric Cooperative we value our member relationships. We want you to understand how we utilize member information and our commitment to ensuring confidentiality, privacy, and data security. If you have any questions regarding how SIEC protects information, please contact us at 800-607-2027.
16. DISPUTE RESOLUTION The Cooperative shall attempt to resolve any claim or dispute which may arise between the Cooperative and a member, former member, or customer who has received electric service in a good faith manner. In resolving such disputes, the Cooperative shall give consideration to: (1) applicable laws: (2) rules and regulations imposed by state and federal agencies; (3) the Cooperative’s Articles of Incorporation; (4) the Cooperative’s Bylaws, policies, practices, plans, and procedures; (5) industry standards; and (6) the individual facts and circumstances regarding the claim or dispute. If a member, former member, or customer who has received electric service is not satisfied with the Cooperative’s resolution of the claim or dispute, all matters subject to the jurisdiction of the Iowa Utilities Board shall be resolved by the Iowa Utilities Board or, if and when appropriate, the applicable regulatory body with jurisdiction over the Cooperative and the matter. All other claims and disputes shall, at the request of either the Cooperative or the member, former member, or customer, who has received electric service, first be submitted to mediation conducted by an impartial mediator agreed to by the parties. In the event the claim or dispute is not resolved through mediation, then such shall, at the request of either the Cooperative or the member, former member, or customer who has received electric service, be submitted to binding arbitration to be conducted in accordance with the policies adopted by the Board of Directors of the Cooperative. In absence of such policies, or in the event such policies are incomplete, the provisions of Iowa Code 679A (Arbitration), as it may be amended from time to time, shall apply to the extent it is not inconsistent with the policies adopted by the Cooperative. Notwithstanding the foregoing, the Cooperative reserves the right to pursue collection of a debt owed by any member, former member or customer who has received electric service through other means, including but not limited to use of collection agency, small claims court, and other applicable courts. Further, any claim where the amount in controversy is less than the small claims jurisdictional amount may be resolved without utilizing the alternate dispute resolution procedures set forth in this paragraph 16. Every member, by becoming or continuing to be a member, agrees to the foregoing, and agrees to be bound by the Articles, Bylaws, and all other governing documents of the Cooperative. The Bylaws and the Articles of Incorporation constitute an agreement between the Cooperative and the members.
This Agreement shall be subject to the approval of the Board of Directors of the Cooperative, and shall become effective upon such approval and shall remain in full force and effect until terminated as by law allowed.
By drawing your signature in the box below, you are consenting to the electronic submission of this Application and the terms and conditions set forth herein. Upon signing and submitting this Application, this document shall serve and will constitute your Certificate of Membership once acknowledged by the Cooperative. The option to print the completed Application will appear in your confirmation email.  A copy may be obtained by contacting the Cooperative at 1-800-607-2027 or coming into the Cooperative's office during business hours. 
Member Applicant has executed this Agreement on the Date and Time submitted below.

Legal Agreement

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