Annual Tune-Up Open Enrollment Form

Annual True-Up Open Enrollment Form

Company

This field is for validation purposes and should be left unchanged.

Member Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Is the Service Address the Same as the Mailing Address?(Required)

Yes

Mailing Address

(If different than above)

Street Address Address Line 2 City State ZIP Code

I understand that I can only change from Option 2 – Indefinite Rollover to the Option 1 – Annual True-Up between January 1 and January 31.(Required)

By checking this box I understand that I am agreeing to the above statement.

My election for Option 1 – Annual True-Up will be effective as of January 2026.(Required)

By checking this box I understand that I am agreeing to the above statement.

I understand that my account will only be credited any remaining unused balance of kWh up to a maximum of three thousand (3,000) kWh.(Required)

By checking this box I understand that I am agreeing to the above statement.

Today's Date (MM/DD/YYYY)(Required)

Member Signature(Required)

By typing your name in this field, you are stating that you understand and agree to the terms listed on this form.

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