Line Retirement Agreement

I request Wiregrass Electric Cooperative, Inc. (WEC) retire a section of distribution line near: Map Location*

This line has not been in service for approximately: Amount of Years*

Account Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone

Cell Phone*

WEC Account #*

Email*

Member Consent*

I hereby verify the above information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.

It will not be needed in the future. I am the recorded owner of the property where said distribution line presently exists or have power of attorney or authority to make decisions concerning such property.

If for any reason I request the line to be reconstructed, I will be receptive to subsidize construction of said line in
the form of aid to construction.

Member Electronic Signature (Full Name)*