Application for Special Capital Credit Retirement of Estates

If you would like to submit your application in person or through the mail, click here for a PDF version. For any questions, contact Customer Service at 704-289-3145.

Name

This field is for validation purposes and should be left unchanged.

Deceased Member's Name(Required)

First Last

Deceased Member's Address at time of Death

Street Address Address Line 2 City State ZIP Code

Capacity in which undersigned makes application for special capital credit retirement:(Required)

Executor of the deceased member's will.

Administrator of the deceased member's estate.

Relative of the deceased member (no will and no administrator appointed).

Please provide the deceased member's will.(Required)

Max. file size: 10 GB.

Please provide the deceased member's death certificate.(Required)

Max. file size: 10 GB.

Please provide the deceased member's death certificate.(Required)

Max. file size: 10 GB.

Please provide the deceased member's Letters of Administration.(Required)

Max. file size: 10 GB.

Please provide the deceased member's death certificate.(Required)

Max. file size: 10 GB.

Relationship to deceased member(Required)

Name of Applicant(Required)

First Last

Mailing Address of Applicant(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number of Applicant(Required)

Terms and Conditions

This special capital credit retirement program is in accordance with the Cooperative's bylaws and will be administered in accordance with the Cooperative's estate retirement guidelines. Upon approval of this application, the Cooperative will pay all previously allocated, unretired capital credits (excluding Generation & Transmission allocations) on a net present value discounted basis. Payment will include estimates for any earned, but unallocated margins. If the application is incomplete or not approved, I understand the unretired capital credits will be handled in accordance with the Cooperative's bylaws regarding general retirements. Payment will be distributed to the estate of the deceased, the Administrator of the estate or to a named heir when only a single heir is named, depending on the documentation provided. By signing below, I agree to accept these terms and conditions.

Signature(Required)

Print Name(Required)

Title (Executor, Administrator, Relative)(Required)