Contact Us
Personal Credit Application
Business Account Application
Auto Debit Authorization
Employment Application
W9 Tax Form

Name

Contact Cooperative Energy Co.

Energy is our specialty. Providing the highest quality service is our priority.

1708 Pierce Ave, PO Box 254 Sibley, IA 51249 | 712-754-2586

First Name *

Last Name

Email Address *

Message *

Personal Credit Application

Personal Credit PDF Application

*Please also complete and submit W-9 form if you plan to be a shareholder now or in the future.

Name

Personal Credit Application and Agreement

Your Social Security number will be required to set up a new account. Please contact Cooperative Energy Company after submitting this application to provide this information

Application for *

Fuel Cards

Propane

Fuel/Gasoline

Other

Is this a joint application? *

Yes

Number of cards requested *

Credit Limit *

Amount of desired monthly credit ($)

APPLICANT INFORMATION

First Name *

Middle Initial

Last Name *

Date of Birth *

Street Address *

City *

State *

ZIP *

Mailing Address *

City *

State *

ZIP *

Home Phone

Cell Phone *

Email *

Do you own or rent your home? *

Own

Rent

How did you find out about Cooperative Energy? *

Friend/neighbor/business associate

TV advertisement

Radio advertisement

Newspaper advertisement

CEC Energy Specialist Team

CEC employee

Social Media

Other? Please tell us...

How long have you lived at this address? *

Estimate to the nearest year

EMPLOYMENT

Applicant's Current Employer *

Position / job title *

Length of employment *

Employer Address

City

State

ZIP

Applicant's Monthly Income *

BANK or FINANCIAL INSTITUTION

Bank Name *

Bank Branch *

Bank Officer *

Employer Address *

City *

State *

ZIP *

Bank Phone *

Account Type *

Authorization *

I hereby authorize bank named above to release information requested for the purpose of obtaining and / or reviewing credit

CREDIT REFERENCES

List three business references where credit has been extended

Reference #1 *

Complete Address *

Phone *

Reference #2 *

Complete Address *

Phone *

Reference #3 *

Complete Address *

Phone *

Has applicant filed bankruptcy within the past seven years? *

Yes

If yes, please provide date and location of filing

Signature

Applicant signature *

Business Account Application

Business Credit PDF Application

*Please also complete and submit W-9 form if you plan to be a shareholder now or in the future.

Web Site

Business Account Credit Application and Agreement

Your Social Security number will be required to set up a new account. Please contact Cooperative Energy Company after submitting this application to provide this information

Application for *

Fuel Cards

Propane

Fuel/Gasoline

Other

Number of cards requested *

Credit Limit *

Amount of desired monthly credit ($)

APPLICANT INFORMATION

Legal Business Name *

include all trade names, DBA's, divisions or subsidaries

Street Address *

City *

State *

ZIP *

Mailing Address *

How did you find out about Cooperative Energy? *

Friend/neighbor/business associate

TV advertisement

Radio advertisement

Newspaper advertisement

CEC Energy Specialist Team

CEC employee

Social Media

Other? Please tell us...

City *

State *

ZIP *

Business Information

Type of business *

Do you have a Sales Tax Exemption Certificate?

A copy will need to be mailed to Cooperative Energy Company for proof.

Describe business

Estimated Annual Sales *

Time in business

Business Contact *

Phone *

Email *

BANK or FINANCIAL INSTITUTION

Bank Name *

Bank Branch *

Bank Officer *

Bank Address *

City *

State *

ZIP *

Bank Phone *

Account Type *

Authorization *

I hereby authorize bank named above to release information requested for the purpose of obtaining and / or reviewing credit

TRADE REFERENCES

List three business references where credit has been extended

Reference #1 *

Complete Address *

Phone *

Reference #2 *

Complete Address *

Phone *

Reference #3 *

Complete Address *

Phone *

Has applicant filed bankruptcy within the past seven years? *

Yes

If yes, please provide date and location of filing

Signature

Business Name: *

Applicant signature *

Joint applicant signature

Auto Debit Authorization

Auto Debit PDF Application

Url

Authorization for automatic debit

To authorize automatic debit, please mail the completed PDF form and a copy of your voided check to:

Cooperative Energy Company - 1708 Pierce Ave PO Box 254 Sibley, IA 51249

To work directly with a Cooperative Energy Company representative, please fill out and submit the form below.

Contact Name *

Your Position *

Email Address for Company Contact *

Financial Institution

Location

Authorization by *

*This authority will remain in effect until written notification is provided to cancel it, allowing the financial institution sufficient time and a reasonable opportunity to act on it.

Employment Application

Employment PDF Application

Web Site

Employment Application

1708 Pierce Ave, PO Box 254 Sibley, IA 51249 | 712-754-2586

Personal Information

First Name *

Middle Initial

Last Name *

Current Address *

Phone Number *

Email Address

Position applying for *

Date Available *

How did you hear about this job opening?

Desired Salary

Are you authorized to work in the U.S.? *

Yes

Have you ever worked for this company in the past? *

Yes

If you have worked with this company before, please explain your experience.

Education

High School *

City, State of High School *

College

City, State of College

Area of Study

Did you graduate?

Yes

Degree

Other Schooling

City, State

From

Did you graduate?

Yes

Diploma

References

Full Name *

Company

Relationship *

Phone *

Address

City, State, Zip

Full Name *

Company

Relationship *

Phone *

Address

City, State, Zip

Full Name *

Company

Relationship *

Phone *

Address

City, State, Zip

Previous Employment

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for leaving

May we contact your previous supervisor for reference?

Yes

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for leaving

May we contact your previous supervisor for reference?

Yes

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for leaving

May we contact your previous supervisor for reference?

Yes

Computer Experience

Computer Hardware / Software Experience

Microsoft Excel Microsoft Word Microsoft Powerpoint Ten-key Calculator

Typing (Words per minute)

Other skills

Military Service

Military Branch

From

Rank at discharge

Type of discharge

If other than honorable, explain

Authorization

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be ground for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree that, if hired, my employment is for no definite period and may regardless of the date of payment of my wages and salary, be terminated at any time without any prior notice.

Applicant's Digital Signature *

W9 Tax Form

W9 Tax Form

The latest version of the Request for Taxpayer Identification Number and Certification (W9) form can be found on the IRS website.

Download or print yours today.

Forms

Contact Us

Personal Credit Application

Business Account Application

Auto Debit Authorization

Employment Application

W9 Tax Form

Contact Us

Contact Cooperative Energy Co.

Energy is our specialty. Providing the highest quality service is our priority.

1708 Pierce Ave, PO Box 254 Sibley, IA 51249 | 712-754-2586

Personal Credit Application

Personal Credit Application and Agreement

Your Social Security number will be required to set up a new account. Please contact Cooperative Energy Company after submitting this application to provide this information

APPLICANT INFORMATION

EMPLOYMENT

BANK or FINANCIAL INSTITUTION

CREDIT REFERENCES

Signature

Business Account Application

Business Account Credit Application and Agreement

Your Social Security number will be required to set up a new account. Please contact Cooperative Energy Company after submitting this application to provide this information

APPLICANT INFORMATION

Business Information

BANK or FINANCIAL INSTITUTION

TRADE REFERENCES

Signature

Auto Debit Authorization

Authorization for automatic debit

To authorize automatic debit, please mail the completed PDF form and a copy of your voided check to:

Cooperative Energy Company - 1708 Pierce Ave PO Box 254 Sibley, IA 51249

Employment Application

Employment Application

1708 Pierce Ave, PO Box 254 Sibley, IA 51249 | 712-754-2586

Personal Information

Education

References

Previous Employment

Computer Experience

Military Service

Authorization

W9 Tax Form

W9 Tax Form