Capital Credit Address Verification Form Address Verification As a former member of New Hampshire Electric Cooperative (NHEC), you have received a letter so that NHEC can confirm your current mailing address. This information will only be used by NHEC for the purpose of ensuring the accuracy of your capital credit account.We would appreciate it if you could provide the information requested below by January 15, 2021. We are trying to validate inactive account information and update our records. If you do not confirm this information, it could result in a delay in any future correspondence, or payment of capital credits. Please enter the Customer #/Capital Credit # that is listed in the letter. * RequiredAre you the person whose name is on this letter? * RequiredYesNoMailing Address VerificationWe need to update our records, please verify if the address listed in the letter is your current mailing address. If it is not, please update it. Is the address listed on this letter your current mailing address? * RequiredYesNoCurrent Mailing Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Service Location VerificationIf you had service from NH Electric Cooperative in the past, please provide us that service address. Have you had service with NH Electric Cooperative in the past? * RequiredYesNoPast Service Address/location Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Consent * Required I have verified that the information provided is accurate.Name of individual that has verified this form First Last