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Request to Remove/Add Name to Membership

Request to Remove Name from Membership

Reason for Membership Conversion
Requested changes may require additional legal documentation. Any changes made to Membership are subject to Sierra Electric Cooperative, Inc. Bylaws. A copy of the Bylaws can be provided upon request. 
Named to be Removed

Removed name understanding

I understand that removing my name from this account, I will no longer have the ability to make changes or access any information on the membership listed above.  I understand that removing my name does not relieve me, my estate, personal representative and heirs, from any debts due the Cooperative prior to the date of this form.  I understand that the interest of any patronage capital belonging to the joint membership will be passed to and recorded in the name of the remaining membership holder. 
Signature (Name to Be Removed)
Remaining Member

Remaining Member understanding

I agree to the conversion of the above listed joint membership into a single membership in my name only.  I understand that I will solely be responsible for any debts due the Cooperative from the date of this form forward. 
Signature (Name of Remaining Member)

Request to Add Name to Membership

Reason for Membership Conversion
Requested changes may require additional legal documentation. Any changes made to Membership are subject to Sierra Electric Cooperative, Inc. Bylaws. A copy of the Bylaws can be provided upon request. 

Adding name understanding

I understand that by adding the name to the account, It will share jointly the membership listed above and agree to abide by the terms of membership
Signature (Name to be Added)
Signature (Name of Original Member)
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Statement of Non-Discrimination

In accordance with Federal civil rights laws and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs).  Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form.  To request a copy of the complaint form, call (866) 632-9992.  Submit your completed form or letter to USDA by:

1. Mail:  US Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410

2. Fax:  (202) 690-7442; or

3. Email: program.intake@usda.gov

Sierra Electric Cooperative, Inc. is an Equal Opportunity Provider and Employer

 

©2023 Sierra Electric Cooperative. A Touchstone Energy Cooperative.

  • Consumer-Member Info
    • The Co-op
    • Membership
      • Residential Rights and Responsibilities
      • Bill Payment
        • Information for Members Experiencing Financial Hardship
      • Understanding your Bill
      • Capital Credits
      • By-Laws
      • Paperless Billing
      • Energy Efficiency Rebates
      • Operation Round Up
      • Co-op Connections
      • Budget Payment Plan
      • New Mexico Public Regulation Commission
    • Together We Save
    • Electric Vehicles
  • Outage Center
    • Reporting an Outage
    • Outage Safety & Tips
  • Service
    • Start, Stop, or Transfer Service
    • Rates, Fees & Charges
    • Solar & Net Metering
    • Surge Protection Device
    • Safety
  • Co-op Community
    • Youth & Education Programs
      • Government-in-Action Youth Tour
      • Safety Coloring Contest
      • Sierra Electric Cooperative Education Foundation & Scholarships
      • Safety Education Programs
  • Announcements & Forms
    • Quick Forms
    • Job Openings
    • Sierra County Broadband Updates