Forms & Applications

Download the Third-Party Notification Form (PDF)

This is a service that gives YVEA members the opportunity to designate a third party to whom notices of discontinuance of service for non-payment will be delivered.

Download the Automatic Service Transfer Form (PDF)

This is a service that requests YVEA to leave the electric service to the service location connected to an owner/landlord’s name in the event that anyone other than the owner/landlord orders it disconnected.

Automatic Payment Authorization

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email(Required)

Daytime Phone Number(Required)

YVEA Account Number(Required)

Address(Required)

Street Address Address 2 City/Town State/Province ZIP/Postal Code

Banking Information

Account Type(Required)

Checking

Savings

Bank Name(Required)

This field is hidden when viewing the form

Bank Routing Number(Required)

This field is hidden when viewing the form

Bank Routing Number (Confirm)(Required)

Bank Routing Number(Required)

Bank Routing Number (Confirm)(Required)

This field is hidden when viewing the form

Bank Account Number(Required)

This field is hidden when viewing the form

Bank Account Number (Confirm)(Required)

Bank Account Number(Required)

Bank Account Number (Confirm)(Required)

Signature (Full Name)(Required)