Rocky R.E.A. For all your Rural Power & Electrical Needs!

Disconnection Form for Rocky R.E.A. Ltd. and Horseguard R.E.A. Ltd service area.
	NAME (first and last):
	ACCOUNT NUMBER
	Final Bill to be sent to: FORWARDING ADDRESS:
	LAND LOCATION:	DISCONNECT DATE : Day		Month	Year
	Are you the OWNER?---- check box if you are	Are you the RENTER?-----check box if you are Landlord's Name ------ Landlord's phone #----
	Home Phone #:: Office Phone #:	E-MAIL ADDRESS : Fax #:
	New Owner's Name		Final Meter Read:--- To close your account, we need to read your meter. Remember you are responsible for the utilities until Rocky R.E.A. Ltd. has a final meter read.
	New Owners Address:		FINAL COMMENTS: