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START NEW SERVICE WITH LICKING VALLEY RECC

Licking Valley RECC offers two quick and convenient options for starting service.

Option 1 – Complete the online application below. This does require you to upload a valid Drivers License for proof of identity. Sending personal information over the internet is never 100% secure. Please do not include your full Social Security Number. We will call you once we receive your application for service and get the remainder of your information at that time.

Option 2 – Drop in our Business office in West Liberty during normal working hours.

Today's Date & Time *

Date

Time

Type of Service Requested *

New Construction
Residential Service
Commercial Service

The Date you are requesting service to be connected *

Is this location your primary residence/ domicile, please indicate below. By checking "This is my primary residence", you are agreeing that you have read and understand the Residential Tax Exemption Law KRS 139.470(7). You can follow this link to the FAQ regarding guidance for the changes made to the Sales & Use Tax:https://taxanswers.ky.gov/Sales-and-Excise-Taxes/Pages/Residential-Exemption-Changes.aspx *

This is my primary residence
This is not my primary residence

Applicants Information

Applicant's Name *

First

Last

Last 4 digits of Social Security Number *

I give LVRECC permission to discuss my account with (name and phone#)

Copy of Valid Drivers License *

Click or drag a file to this area to upload.

Use this location to upload a copy of your DL. If you wish to provide this in a more secure manner, it can be brought by our business office.

Email *

Home Phone *

Mobile Phone

Work Phone

Co-Applicant's Information

If you wish for a secondary name to be listed on this account, provide the information below:

Name

First

Last

Last 4 Digits of Co-Applicant's Social Security #

Copy of Co-Applicant's Drivers License

Click or drag a file to this area to upload.

Current Mailing Address

Current Mailing Address *

City,State *

Zip Code *

Service Address

Address where service is being requested

Service Address *

City *

Meter or Pole Number

If service is already established at this location, please provide either the pole# or Meter#.

Are you purchasing this property? *

Yes
No

If you are renting, provide your Landlords name and phone#

Have you ever had Service with Licking Valley RECC in the past *

YES
NO

Does this location currently have Outdoor Lighting *

Yes
No

If you Answered Yes above, would you like to keep this Outdoor Lighting Active?

YES – I would like to keep the light active
No – Please have it removed

Additional Comments

Digital Signature

Digital Signature *

Checking this box confirms the applicant has read and agrees to the below terms and applicable bylaws of Licking Valley Rural Electric Cooperative. A Licking Valley RECC Representative will contact you regarding your credit check and establishing your account. If we encounter any issues while conducting your credit check over the phone, you may be required to come into the office for verification. You must pay all fees (membership and deposit, if applicable) to our office prior to your service being activated. For new construction accounts, if we have not acknowledged your request within two (2) working days, please contact our office at 606-743-3179.

Digital Agreement *

I understand that checking this box and typing my name in the field provided below is my digital signature

Type your Full Name here to sign this Document Digitally.

Website

Touchstone Energy® Cooperatives is a national network of electric cooperatives across 46 states that provides resources and leverages partnerships to help member cooperatives and their employees better engage and serve their members. By working together, Touchstone Energy Cooperatives stand as a source of power and information to their 32 million member-owners every day.

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