Capital Credit Address Verification Form Address Verification (1) 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 April 1, 2022. 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.* Are you the person whose name is on this letter?*YesNoNo, however I am related to person addressed in letterAre you the person whose name is on this letter? Yes No No, however I am a relative Please indicate if you are the person whose name is on the letter. If :YES", please complete this form indicating your preference on how to payout or donate your capital credits. If "NO" you are NOT the person whose name appears on this letter and are of NO relation-- please send letter back to us so that we can update our recods. If "NO" you are not the person whose name appears on the letter, however you are related to the person whose name appears on the letter, but you are related to an addressee who is deceased, please email: capitalcredits@nhec.com with any estate or trust paperwork noting who are the designated beneficiaries or call 1-800-698-2007Mailing 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?*YesNoCurrent Mailing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest 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?*YesNoPast Service Address/location Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Would you like to donate your Capital Credits to NHEC Foundation Project Care: helps members in need pay their electric bill NHEC Foundation: provides funds for scholarships and grants to local community and charity organizations 50/50 Split donation between Project Care and NHEC Foundation No, I am not interested in donating my capital credits Consent* I have verified that the information provided is accurate.Name of individual that has verified this form First Last Δ