Capital Credit Address Verification Form

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'd appreciate you providing the information requested below by May 1, 2023. 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 Capital Credit number that is listed in the letter.*

Are 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 for your capital credit payment. You are able to donate your capital credit payment as well. If NO, you are NOT the person whose name appears on this letter and are not related to them, please send letter back to us so that we can update our records. Thank you! If NO, but you are related to the person; or you are related but the person is deceased, please email: capitalcredits@nhec.com with any estate or trust paperwork noting the designated beneficiaries, or call 1-800-698-2007

Mailing Address Verification

We 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?*

Current Mailing Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Service Location Verification

If 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?*

Past Service Address/location*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Would you like to donate your Capital Credit?*

Project Care: Assists NHEC members who have fallen behind on their electric bill.
NHEC Foundation: Provides funds for scholarships and grants to local non-profits throughout New Hampshire.
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

Capital Credit Address Verification Form

Address Verification (1)

Mailing Address Verification

Service Location Verification

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