CONFIDENTIAL DESIGNATION OF ACCOUNT VERIFICATION

As provided for in the tariffs of your utility, end user hereby designates General Account Agent Organization to act as end user’s General Account Agent for the purpose of validating and verifying tariffed services provided by your utility in regard to the account verification submitted on this form.

End User acknowledges that your utility will share account data, billing data, and interval data with General Account Agent including bills and notices prior to disconnection. This Confidential Designation shall be valid until the end user or General Account Agent provides the utility with written notice of its termination or until this Confidential Designation is otherwise terminated in accordance with your utility’s tariffs. The designation or use of a General Account Agent does not affect the end user’s responsibilities to timely pay the utility all amounts due and perform and satisfy all other obligations applicable to the end user.

The utility shall not be required to perform services for General Account Agent as agent of the end user that the utility does not already perform for the end user. General Account Agent contact information: S. Michael Brannon Director of Regulatory dor@generalaccountagent.org 217.788.7706