Budget Billing Form

Enroll in the Budget Billing Program here

Terms & Conditions

I understand that submitting this form authorizes Beltrami Electric Cooperative to enroll me in its Budget Billing program for equal monthly payments. I understand my enrollment remains in effect until I notify Beltrami Electric Cooperative to cancel my enrollment in the Budget Billing program, or until I fail to meet the requirements set forth to be eligible to enroll in the Budget Billing Program.

Participation in the Budget Billing Program is voluntary and is offered by Beltrami Electric Cooperative to enable the member to pay an equal amount for electric service each month

For more information, contact our office or complete the form below to enroll.

Date

Month

Day

Year

Account Number *

(Located on bill)

First Name *

Last Name *

Billing Address *

City *

State *

Zip code *

E-Mail Address *

Home Phone *

Please use the format xxx-xxx-xxxx.

Cell Phone

Please use the format xxx-xxx-xxxx.

Have you had active electric service at this location for the last 12 months? *

Yes

* If you have not had service at this location for the last 12 months, you are ineligible to enroll for budget billing at this time.

Which method would you like us to confirm your enrollment? *

Accept Terms & Conditions *

Yes

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Budget Billing Form

Enroll in the Budget Billing Program here