To establish electric service with Palmetto Electric Cooperative, please complete the Application below. To ensure your application process is not delayed, when choosing the Type of Request please adhere to the following: If you are applying for service to a house that has an existing meter please fill out the Residential application. Commercial locations should fill out the Commercial application. If you are building a new home or remodeling an existing home please fill out the New Construction application found on the main page of the member payment portal. If you have any questions, or prefer to apply over the phone, contact our office at 1-800-922-5551 or send an email to csr@palmetto.coop.

Note: All fields with asterisk (*) are required.

Today's Date:  
Date Service is Desired:  *  
Type of Request:   *
Applicant First Name:   *
Applicant Last Name:   *
Applicant Middle Initial:  
Social Security #:--  *
Driver's License #:  
License State:  
Birth Date:    
Employer:  
Landlord's Name or Rental Agency:  
Landlord/Rental Agency phone #:  

Billing Address
Please mail bills to the address shown below:

In Care of Name: (if applicable)  
Street Address/P.O. Box:  *
City:  *
State:  *
Zip Code:   *

Service Address
Address where service is being requested (for new construction please include lot #):

Service Address:   *
Service Type (Construction Required or Existing Service):   *
Meter #:  
Comments:  
E-mail:  *
Confirm E-mail:  *
Primary Phone:--   *
Cell Phone:--  
Work Phone:--   
Spouse Name: 
Spouse SSN:-- 
Spouse Driver's License #:  
Spouse License State:  
Spouse Birth Date:    
Spouse Employer:  

Note: Click here to see Palmetto's Joint Membership Requirements, Section 3.

Online Access
As one of our services, we offer an online application for viewing and paying bills. If you would like to use this service, you can specify an Internet Password and Password Hint at this time. For security purposes, please specify a Password that is at least 4 characters in length.
Internet Password:  
Confirm Internet Password:  
Password Hint:

Existing or Previous Service
Have you ever had service with Palmetto Electric?    
Account Number:

Fee & Deposit Information
Residential:
In addition to the fees shown below, a deposit may also be required for service to be connected. The deposit amount is based on risk factor analysis. When your account is created, you will receive an email with the total amount due on your new account, including the deposit amount and the Membership Fee, if applicable. The deposit is due before electric service will be activated.

Commercial:
In addition to the fees shown below, a deposit will be required. The deposit amount is based on a two month average bill. When your account is created, you will receive an email with the total amount due on your new account.

Membership Fee:  
Processing Fee:  

Service Address for existing or previous service with Palmetto Electric Cooperative:  
Please select your preferred Billing Method:   *
 
Checking this box confirms that I have read and understand the Bylaws outlined in the Members Manual of Palmetto Electric Cooperative.