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Forms

Polk-Burnett offers many forms on its website as a convenience for you. Forms are PDFs and must be printed and submitted.
Please let us know if we can assist further. 800-421-0283  |  e-mail

Account Change
Add a Name to Electric Account
Affidavit by Electrical Contractor
Application for Electric Service
Automatic Bill Payment, Electric
Certification of Winterization
Cogeneration Agreement
Cogeneration Application
Connect Electric Service for Prospective Buyer
Consumer Deposit, New Electric Service
Contact Information (Update)
Critical Medical Need for Electricity
Data Sheet - New Service
Data Sheet - Rebuild Existing Service
Disconnect Electric Service Form    
Easement, Electric Rights-of-Way
Evergreen Green Power Program Application
Inspection Connection Certification
Material/Equipment Waiver Form, Electric
Operation Round-Up Application
Prepay Your Way Agreement
Propane Application
Rebate Form: EnergySense ECM Blower / Central Air / Heat Pump (HVAC)
Rebate Form: EnergySense Appliance & Recycling
Rebate Form: EnergySense Commercial / Ag / Industrial
Rebate Form: EnergySense Compressed Air
Rebate Form: EnergySense Conservation  
Rebate Form: EnergySense Custom
Rebate Form: EnergySense Demanufacturing / Recycling 
Rebate Form: EnergySense Home Performance Audit 
Rebate Form: EnergySense Home Improvement Measures 
Rebate Form: EnergySense Lighting Rebate 
Rebate Form: EnergySense New Home Rebate & Checklist 
Rebate Form: EnergySense Wind / Solar PV / E-Vehicle 
Remove a Name from Electric Account
Security Light Application
Uniform Dwelling Code Electrical Inspection Certification 
Wood Chip Signup List

 

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