Capital Credits Claim Form

If your name or the name of a family member who is deceased and you are responsible for their estate is listed in the Unclaimed Capital Credits listing, please fill out the form below and a Coastal Electric representative will be in contact with you. If you find the names of a friend or family member, please direct them to this page and have them fill out the form below.
*Name in the Listing:
*Your Name:
*Your Address:
Address Line 2:
*Zip Code:
*Your Phone Number:
*Your E-Mail Address:

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