Account Information

SmartPAY Interest Form

This form is to express interest in our SmartPAY program. This is NOT a way to sign-up for new service. This form is only for existing Cullman Electric members.

If you complete this form, a member services team member will contact you about changing your existing account to a SmartPAY account.

First Name

Last Name

Account Number

Physical/Service Address (911 Address)

Service/Physical Address (911 Address)

Address 2

City/Town

State

ZIP/Postal Code

Contact Information

Primary Phone Number

Email Address

Would you like to Sign-Up for SmartPAY?