Start Prepay Service Please enable JavaScript in your browser to complete this form.Today's Date & Time *DateTimeThe 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 residenceThis is not my primary residenceApplicants InformationApplicant's Name *FirstLastLast 4 digits of Social Security Number *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 PhoneWork PhoneCo-Applicant's InformationIf you wish for a secondary name to be listed on this account, provide the information below:NameFirstLastLast 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. Previous AddressPrevious Street Address: *City, State *Zip Code *Current Mailing AddressCurrent Mailing Address *City,State *Zip Code *Service AddressAddress where service is being requestedService Address *City *Meter or Pole NumberIf service is already established at this location, please provide either the pole# or Meter#.Have you ever had Service with Licking Valley RECC in the past *YESNOIf you Answered yes above, please list your previous account #Does this location currently have Outdoor Lighting *YesNoIf you Answered Yes above, would you like to keep this Outdoor Lighting Active?YES - I would like to keep the light activeNo - Please have it removedAdditional CommentsDigital SignatureDigital 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 signatureType your Full Name here to sign this Document Digitally.PhoneSubmit Share this:TwitterFacebook