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Utilities District of Western Indiana REMC Home

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EASEMENT

REMC Account Number:

Street

Address:

Location:

City:

STATE OF INDIANA

) ) SS: )

COUNTY OF

KNOW ALL MEN BY THESE PRESENTS, that the undersigned

(unincorporated association hereafter called Grantor, in consideration of its undertaking to construct and operate a system to distribute electricity to residents of the locality of the real estate described below, within the above-named county, or within the service territory of the Grantee, and for other good and valuable consideration, the receipt whereof is hereby acknowledged, does grant unto Grantee, whose post office address is , Indiana, and to its successors and assigns, the right to enter upon the lands of the undersigned, situated in the County of , State of Indiana, and more particularly described as follows:

A tract of about acres situated in County,

Township, Range, Grant or Section No.

and more particularly described in Deed Record Book

Page number as follows:

and to place, install, construct, bury, operate, repair, maintain, relocate and/or replace thereon or thereunder, and in, under or upon all streets, roads or highways abutting and lands, an electric transmission or distribution line or underground system, or any part thereof, to cut, trim and control the growth by chemical means, machinery or otherwise of trees, shrubbery and vegetation that may interfere with or threaten to endanger the operation and maintenance of said line or system, including any control of the growth of other vegetation in the right-of-way which may incidentally and necessarily result from the means of control employed, and to cut down from time to time all dead, weak, leaning or dangerous trees, shrubs and vegetation that are near enough to strike the wires if such trees should fall or which are near enough to an underground system for the roots to interfere with the system, damage the system, or cause a safety hazard. In granting this easement, it

is understood that at structure locations, only a single structure (and appurtenances) will be used, and that the location of the structure will be such as to form the least possible interference to farm operations (if applicable), as long as it does not materially increase the cost of construction, cause the relocation of existing distribution lines or electric facilities or otherwise unduly impinge upon the existing system. Reservation of the full use and enjoyment of the said land insofar as it shall not interfere with the easement hereby granted is hereby expressly made.

The Grantee is further permitted to license, permit, or otherwise agree to the joint use or occupancy of all poles, lines, trenches, conduits and systems (including underground systems) by any other person, association or corporation for electrification, telephone, cable, television, computer, energy transmission, signal transmission or communication purpose.

The undersigned agree(s) that all poles, wires and other facilities, including any main service entrance equipment, installed on the above-described land at the Grantee's expense shall remain the property of the Grantee, removable at the option of the Grantee, upon termination of service to, on or under said lands.

The undersigned covenant(s) that he/she/they/it is/are the owner(s) of the land on which this easement is granted and that the lands are free and clear of encumbrances and liens of whatsoever character except those held by the following persons except as set forth in attached exhibits. The aforesaid easement runs with the land and includes the right of Grantee or its successors at any time to enter upon the said land, with the necessary tools and equipment, to service, maintain, repair or otherwise do acts mentioned. It is further understood that, whenever necessary, words used in this instrument in the singular shall be construed to read in the plural and that works used in the masculine gender shall be construed to read in the feminine.

IN WITNESS WHEREOF, this easement is signed as of the day of , 20

Grantor

STATE OF INDIANA

) ) SS: )

COUNTY OF

Before me the undersigned, a Notary Public for and in personally appeared the Grantor whose signature appears above and acknowledged the execution of the foregoing instrument as his/her/their

free and voluntary act this day of 20

(N.P Seal)

Notary Public

Printed or Typed Name

Resident of County, Indiana.

My commission expires:

This document prepared by

I affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security number in this document, unless required by law.

(Name of Preparer)

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What the Utilities District of Western Indiana REMC Home is

The Utilities District of Western Indiana REMC Home is the standard residential service agreement and account form used to establish electric and related utility services with the cooperative. It defines parties, service address, billing and deposit terms, meter access, and basic customer responsibilities. The form documents authorization for billing, consent to credit checks where applicable, and agreement to the utility's terms of service, safety rules and property-entry provisions. It is used at account opening, ownership transfer, or when customers request service changes requiring a signed record.

Why this form matters for customers and the cooperative

The Utilities District of Western Indiana REMC Home creates a clear, legally binding record of service terms, payment obligations, and permissions needed to safely and reliably deliver utility service.

Why this form matters for customers and the cooperative

Who completes and signs the Utilities District of Western Indiana REMC Home

The form is used by a mix of account holders, cooperative staff, and authorized agents involved in initiating or changing residential utility service.

  • New residential customers and property owners who request service activation or transfer of service.
  • Authorized agents or third parties acting under a power of attorney for account holders.
  • Utility customer service representatives, field technicians, or billing personnel who process and verify the application.

Step-by-step: completing the Utilities District of Western Indiana REMC Home

Follow these core steps in order to complete the account form accurately and ensure timely activation of residential utility service.

  • 01
    Gather IDs: Collect government ID and proof of residency before starting the form.
  • 02
    Complete contact data: Enter full legal name, service and mailing addresses, and reliable contact info.
  • 03
    Confirm account details: Review deposit, billing cycle, and any special meter or program selections.
  • 04
    Sign and submit: Sign in the signature block and return via the accepted submission method.

How to update or revise an existing account form

Use this procedure when transferring service, changing account names, or updating billing details.

01

Request change:

Contact customer service to request the specific amendment and confirm required documentation.
02

Provide proof:

Submit ownership transfer documents, power of attorney, or ID as requested for verification.
03

Complete amendment:

Fill the update section or a new form and mark it as a revision.
04

Sign authorization:

Authorized parties sign the revised form; electronic signatures are acceptable where permitted.
05

Confirm processing:

Ask for a confirmation number or receipt once the revision is entered.
06

Retain records:

Keep a copy of the revised form for your records and dispute resolution.

How account submission and activation typically flow

This sequence describes the typical routing from submission to service activation and billing setup.

  • Submission: Customer returns completed form to the utility by accepted channel.
  • Verification: Staff validate identity, address, and any required deposits or authorizations.
  • Processing: Billing and meter teams schedule connection or transfer and set up the account.
  • Confirmation: Customer receives confirmation of activation, meter read schedule, and account number.

Online completion and routing settings to check

When completing the Utilities District of Western Indiana REMC Home electronically, confirm these workflow settings so records and notifications route correctly.

Field Configuration
Signature Type Specify e-signature with audit trail
Signer Authentication Email plus SMS code for stronger validation
Notification Recipients Customer | Billing | Field Ops
Document Retention Store signed record in secure archive for retention period

Digital signing and file format considerations

Use platforms that produce a complete audit trail and export signed records in common formats for archival.

  • File Formats: PDF | DOCX supported
  • Integrations: Salesforce | Microsoft 365 | NetSuite
  • Security: TLS 1.2/1.3 in transit

Ensure the chosen system meets legal and operational requirements for authentication, retention, and retrieval of signed records.

Key sections included in the Utilities District of Western Indiana REMC Home

The document contains standard sections to record service terms, customer data, billing preferences and operational consents required for residential utility delivery.

Account Information

Identifies account holder, co-account holders, and authorized agents with contact details for billing and notifications.

Service Location

Specifies the physical address, meter number if known, and any access instructions needed by field personnel.

Billing & Deposits

Records billing cycle, preferred billing method, deposit requirements, and any deferred payment agreements.

Authorizations

Grants permission for meter access, disconnection notices, and sharing of limited information for service setup or credit checking.

Safety & Liability

Summarizes customer obligations for on-site safety, meter tampering prohibition, and reporting outages or hazards.

Signature & Consent

Provides space for signature, date, and optional electronic consent language to meet ESIGN/UETA standards.

Supporting documents commonly submitted with the form

Attaching the right supporting documents expedites verification and reduces follow-up requests during account setup.

Proof of Identity

Government-issued photo ID such as driver's license or passport to verify the signer.

Proof of Ownership or Tenancy

Lease agreement, deed, or mortgage statement to confirm the right to request service.

Deposit Payment

Receipt or payment confirmation for required service deposit if applicable.

Power of Attorney

Signed POA document when an agent is acting on behalf of the account holder.

Essential data points the utility collects

Account Name: Primary account holder
Service Address: Physical service location
Contact Details: Phone and email
Identification: Government ID number
Billing Preference: Paper or electronic billing
Authorized Agent: POA or third-party contact

eSignature vendor comparison relevant to electronic account forms

A concise feature and pricing comparison for common eSignature vendors. signNow is placed first per structured comparison guidance.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Practical tips for accurate and efficient completion

Small checks reduce errors and processing time—use these practical steps when filling or reviewing the form.

Verify Names
Match the account name to government ID and billing records to avoid mismatches that delay activation.
Use Standard Formats
Enter dates as MM/DD/YYYY and include full ZIP+4 when available for timely routing and billing.
Confirm Authorization
Ensure signers have legal authority; attach a power of attorney when an agent signs on behalf of the account holder.
Keep Copies
Retain a signed copy in an accessible archive for billing disputes and service history verification.

Common errors that slow processing

  • Incomplete service or mailing address information requiring follow-up verification and delay.
  • Mismatched names between ID and account application that trigger additional identity checks.
  • Missing signature or unsigned fields that render the form unusable for account activation.
  • Insufficient supporting documentation for ownership or tenancy verification causing processing delays.

Risks and potential consequences of incorrect or incomplete forms

Service Delay: Activation may be postponed until verification is complete
Deposit Loss: Failure to provide required deposit could result in service refusal
Billing Errors: Incorrect address or account data may cause misdirected bills
Legal Exposure: Unauthorized signers can cause liability disputes
Data Privacy: Improper handling of PHI may trigger HIPAA obligations
Record Retention: Insufficient retention risks noncompliance with auditing requirements

Typical timelines and processing expectations

Processing times vary by cooperative load and documentation completeness. Expect the following typical timelines.

Application Processing:

2–5 business days after complete submission

Service Connection:

Scheduled within 1–10 business days depending on meter access and crew availability

Deposit Posting:

Posted to account immediately upon payment; refund policies per tariff

Billing Cycle Start:

Next billing cycle after activation unless prorated billing applies

Dispute Resolution:

Allow 30 days for formal account disputes to be investigated

Notarization and witness process when required

If a signature must be notarized or witnessed, follow this authentication workflow to ensure validity.

01

Prepare Document

Ensure signature blocks are unsigned until in front of the notary or witness

02

Verify Identity

Signer presents acceptable ID per state notary rules

03

Notary Acknowledgement

Notary records the acknowledgment and signs the notarial certificate

04

Witness Signing

If witness required, witness signs and prints name and address

05

Audio/Video Recording

For RON, the session may be recorded and retained per state rules

06

Journal Entry

Notary logs the act in the journal where required by state law

07

Return Document

Submit the notarized copy to the utility per the instructed channel

08

Retain Proof

Keep a copy of the notarized record and any RON session ID for your files

Who can legally sign this form

Account Holder

The named account holder on the form is the primary legal signer and responsible party for charges and compliance with utility rules; ensure the name matches identification presented.

Authorized Agent

An agent with a valid power of attorney or written authorization may sign on behalf of the account holder; attach the POA and verify its scope before acceptance.

Real-world examples of form use

These brief customer stories show common scenarios where the form is used and how electronic signing helped.

Optica Ventures Use

Optica Ventures used the online account form for new property activations

  • Bulk onboarding of rental units reduced manual paperwork
  • The cooperative processed multiple accounts faster while maintaining a complete audit trail for compliance and customer records.

Martin Properties Case

Martin Properties completed tenant transfers remotely during off-hours

  • Mobile signing allowed remote signing by authorized managers
  • Using verified electronic records enabled prompt meter assignments and minimized service downtime for occupants.

Frequently asked questions about the Utilities District of Western Indiana REMC Home

Answers to common questions about completion, signatures, and submission of the residential service form.


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