Residential Membership & Electric Service Application Name First Middle Last Social Security # Drivers License Photo Verification Upload Upload requirementsOne file only.100 MB limit.Allowed types: gif, jpg, png, svg. Do you have a co-applicant? Yes No Do you agree to a soft utility credit check? Yes No Co-Applicant Information Co-Applicant Name First Middle Last Co-Applicant Social Security # Co-Applicant Drivers License # Exp. Date State of Issue Co-Applicant Drivers License Photo Verification Upload Upload requirementsOne file only.10 MB limit.Allowed types: gif, jpg, png, svg. Co-Applicant Employer Co-Applicant Employer Phone Property Status Own Rent/Landlord Billing Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Service (911) Address Cell Phone Email Date Service Requested Structure Type Residence Mobile Home Water Well (Metered Separately) Commercial/Industrial Barn (Metered Separately) Other… Enter other… Square Feet Location Type New Location Existing Location Operation Round Up Opt In Opt Out Operation Round Up is a program that rounds up your bill to the nearest dollar. These funds are then used for charitable donations by our PenTex Energy Charitable Foundation. Alerts Receive text/email alerts Do not receive text/email alerts Bill Information Receive bill via mail Receive bill electronically via email Both I agree to the terms of service. Agreement Upon compliance with the requirements set forth below, an Applicant shall automatically become a Member on the date of connection for electric service. The Applicant/Member hereby makes application for membership, and agrees to purchase electric service from PENTEX ENERGY (“PenTex”) upon compliance with the PenTex By-Laws, (a copy is acknowledged as received) and the following Terms and conditions: 1. Service. PenTex agrees to use reasonable diligence to provide electric utility service to a point of delivery at Member’s service location. The electric service contracted for herein is to be provided and taken in accordance with the provisions of this Agreement and PenTex’s Tariff. SAID TARIFF IS A PART OF THIS AGREEMENT TO THE SAME EXTENT AS IF FULLY SET OUT HEREIN AND IS ON FILE AND AVAILABLE AT THE PENTEX HEADQUARTERS IN MUENSTER, TEXAS. Any tariff provision (including rates) may be changed by order or consent of any regulatory authority having jurisdiction thereof whether or not at the request of PenTex. A security deposit may be required in addition to the standard $25.00 connect fee. 2. Payment. Member agrees to purchase and pay for electric service in accordance with PenTex’s Tariff. Monthly, PenTex will submit a statement to Member for electric service rendered. Member agrees to pay the total amount shown on such statement within sixteen (16) days from its invoice date. If Payment is not received by the 16th day; a 5% delinquent fee may be assessed. Payment shall be made to PenTex Energy in Muenster, Texas. 3. Easement. The undersigned hereby grants to PenTex the right to construct electric facilities and to cut or trim trees as necessary on property owned or controlled by said undersigned. The undersigned further agrees to grant PenTex’s representatives, employees, and assigns the right of ingress and egress on and across property owned or controlled by said undersigned for the purpose of inspection and maintenance of PenTex facilities including periodic meter reading; and, if necessary, the right to install a PenTex lock in a locked gate for unlimited access by authorized PenTex representatives, employees and assigns. THE UNDERSIGNED AGREES TO HOLD PENTEX HARMLESS AND FREE OF LIABILITY FOR IMPROPER GRANT OF EASEMENT IF INDIVIDUAL IS NOT LEGAL OWNER OF PROPERTY. 4. Breach. Upon failure to make payment or perform any obligation under this Agreement, PenTex shall have the right to discontinue service as well as to use other remedies that may be provided by law. PENTEX’S LIABILITY IS LIMITED as provided in its Tariff. 5. Member’s Installation. Member warrants that installation (including all conductors, switches, equipment, wiring, and protective devices of any kind) is constructed and will be maintained in accordance with the National Electrical Safety Code of the American Standards Association as well as applicable laws or ordinances. 6. Entire Agreement. This Agreement, including the By-Laws and any addendum regarding payment for line extension costs, constitutes the entire agreement between the parties and supersedes all prior agreements between Member and PenTex for the Service herein described. Member agrees that PenTex, its agents, and employees have made no representations, promises or any inducements, written or verbal, which are not contained herein. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Leave this field blank