Gift certificates from Polk-Burnett are ideal for birthdays, anniversaries and all special occasions. They can be purchased in any amount at co-op offices in Centuria and Siren, Monday through Friday, 8 a.m. to 4:30 p.m. or call 800-421-0283.
Links to Polk-Burnett forms are provided below for your convenience. Many are fillable forms, meaning you can complete them on the computer, but then must print them out and submit them via mail, fax or in person with signatures and/or supplemental materials. Forms are posted as Adobe® PDF files. If you do not have adobe reader or an older version, you can download the free Adobe Acrobat Reader software to open and read PDF files.
Account Change, Electric
Add a Name to Electric Account
Address and Telephone Change
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
Critical Medical Need for Electricity
Disconnect Electric Service Form
Easement, Electric Rights-of-Way
Evergreen Application (Green Power Purchase)
Information Request
Inspection Connection Certification
Material/Equipment Waiver Form, Electric
New Electric Service Data Sheet
Operation Round-Up Application
Propane Application
Rebate Form: EnergySense Home Rebate (Electric)
Rebate Form: EnergySense AC and Heat Pump Rebate (Electric)
Rebate Form: EnergySense Lighting and Appliance Rebate (Electric)
Rebate Form: EnergySense Renewable Energy Incentive (Electric)
Rebuild or Remodel Electric Service Data Sheet
Remove a Name from Electric Account
Security Lights
Uniform Dwelling Code Electrical Inspection Certification