Coastal Electric Cooperative

Residential Service Disconnect Request

To disconnect your service, Please fill out the form below or give us a call at 800-421-2343 during Coastal Electric Cooperative's business hours, 9 a.m. to 5 p.m., Monday to Friday.
There is no charge for disconnecting service. Your meter will be read-out on the disconnect date and any remaining energy charges will appear on your final bill.
Your membership fee and your deposit will automatically be applied to your final bill, unless you have another active account. If you have another active account, the deposit will be transferred to the active account.
Please make sure we have a correct forwarding address for any future capital credit payments due to you and for proper processing of your final bill.

Identity

*Full Name:
Last 4 digits of SSN:
*Account Number:

Service Address to Disconnect

*Disconnection Date:	MM/DD/YYYY
Current Address:
Current City:
Current State:
Current Zip:

Forwarding Address

*Forwarding Address:
*Forwarding City:
*Forwarding State:
*Forwarding Zip:
* Phone Number:
Best time to call:

Coastal Electric Cooperative does not reveal any personal information that users provide to us through our Web site to any third party. All information provided by customers on this form is kept strictly confidential and secure to prevent unauthorized use of personal information.