Agent Enrollment Form – Disclosure

This conversation is being recorded for verification purposes.

I am creating your account today, [current_date].
To ensure the accuracy of the information we have discussed, can you please speak clearly and state your FULL NAME and SERVICE ADDRESS with ZIP CODE?

FULL NAME:
SERVICE ADDRESS: , , , ,

Your ESIID is:

ESIID: 

Is this correct (Yes or No)? 

For the Account Purposes, please confirm your Date Of Birth?

DATE OF BIRTH:

Product Information

  • You have chosen the residential electricity product.
  • This Plan has an Early Termination Fee of $ .
  • This Plan has a contract length of months beginning on the service-start date.

Do you agree to the contract terms of this electricity product (Yes or No)? Customer must answer “YES”

Rate Summary

The electricity rate of cents per kilowatt-hour is an example based on a monthly usage of kilowatt-hours. This rate includes:

  • A fixed energy charge of cents per kilowatt-hour.
  • A monthly base charge of $ .
  • The current delivery charges from your Transmission Utility.
  • This rate does not include standard taxes or future changes in delivery charges set by .

Do you Agree with the rate summary I have outlined for you (Yes or No) ? Customer must answer “YES”

We will submit your account for a 3- day review. Once accepted, we will arrange for your new service to begin on the requested start date of . Please note that it is your responsibility to make any arrangements with your current electricity provider and to pay any early termination fees associated with current active contracts, if applicable.

Do you understand this disclosure and agree to the service start date I have outlined (Yes or No)? Customer must answer “YES”

Customer Authorization

  • Are you at least 18 years old and authorized to select or change the electricity provider for the service address of , , , , (Yes or No)? Customer must answer “YES”
  • Do you agree to become a (REP) customer and allow us to complete the tasks required to switch your electric service from your current REP to Ranchero Power (Yes or No)? Customer must answer “YES”
  • If your enrollment is a switch request, you have 3 business days to rescind this agreement once you receive your terms of service, without penalty. After the period has ended, you may be subject to an early termination fee if you cancel your agreement before the end of your contracted term. Do you understand(Yes or No)? Customer must answer “YES”
  • You will receive an account number and a written copy of the documented terms of service that explain all the terms of the agreement and how to exercise the right of rescission via mail/email within 3-business days from today. This offer is subject to withdrawal at any time prior to finalizing your account set-up and service start date with Ranchero Power. Do you agree (Yes or No)? Customer must answer “YES”
  • You are requesting to receive your Customer Documents in , is this correct (Yes or No)? Customer must answer “YES”

You will receive a welcome e-mail to the address on file with all your new account information. You will also receive login instructions for your free online portal. From your portal you can access account documents, monthly statements, pay your monthly bills, even check your daily and monthly usage. Feel free to contact us at any time if you have any questions. Our Customer Care number is 1-888-204-3202.