Residential Service Application

Complete the application below to apply for electric service with Southeastern Indiana REMC.

Once your application has been submitted, you MUST contact the REMC to have your service energized.

A credit check is required for all new applicants, unless the applicant has an existing active account.

Service connections occur during normal business hours, Monday through Friday, 7:30 a.m - 4:30 p.m. Service cannot be connected after business hours, on weekends, or holidays. Requests submitted after 3:00 p.m. will be processed the next business day.

If you have questions regarding the Residential Service Application, please contact our office at 1-800-737-4111.

Please review the Service Rules & Regulations and the Operation RoundUp Program details prior to submitting your application for residential service.

Today's Date: *

Month

Day

Year

My Customer Service Representative: *

Select the CSR you have been working with.

Full Name: *

Service Address: *

Street Address, City, State, Zip

Mailing Address: *

Street Address, City, State, Zip

E-mail Address: *

Home Phone: *

Business Phone #:

Cell Phone: *

Date of Birth *

Month

Day

Year

Driver's License #: *

Co-Applicant Name:

Former Southeastern IN REMC Member? *

Former Account Name:

Former Account #:

Type of Service: *

Date Service is Desired: *

Month

Day

Year

Type of Home: *

Fuel Source: *

If you selected OTHER, please specify your fuel source.

Do You Rent or Own at the Service Location? *

Terms of Acceptance and Signature: *

I, the applicant for this Residential Service, warrant the truthfulness of the information provided in this application. I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the terms of service outlined in the Service Rules and Regulations of Southeastern Indiana REMC.

Electronic Signature: *

Please type applicant full name here.

Co-Applicant Signature

Type co-applicant name here.

Complete the Process

Copy of Driver's License: *

Max upload size: 50 MB Click "Choose File" to select your driver's license file, and then click "Upload" to add your file to the form. Then click "Submit" to send the form. If successfully sent, you will be redirected to the "Confirmation" page. If your form does not submit properly, click "Choose File" to select your driver's license file again but DO NOT CLICK "UPLOAD". Then click "Submit". If successfully sent, you will be redirected to the "Confirmation" page.

Operation RoundUp Program

Opt In

Opt Out

By default, all accounts are "opted in" to the Operation RoundUp Program. Members who do not wish to participate in the program may "opt out" at any time.

Search form

Residential Service Application