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Request for Additional Service

This form is for current cooperative members who add one or more service locations to their original membership account.  Please do not submit this form before contacting our office.

Please fill in each required field and press the SUBMIT button.  You will receive a confirmation message once all required information* is entered on this form and submitted.

Claverack Rural Electric Cooperative, Inc. offers this electronic form to members of the cooperative for their convenience.  A hard copy of this form is available for completion at our main office or can be requested by mail.

Request For Additional Service
Applicant is:
Intended Use of Service
Description of Service
Physical Address of Location Served:

Status message

Pennsylvania Sales Tax Determination:

Please review the different types of electric usage listed below and check which best describes how you will use electricity at your location.  If an exemption certificate is required under Section C below, please provide one.  If your tax status changes, it is YOUR RESPONSIBILITY to notify the Cooperative.

** CHECK ONE OR TAX WILL BE CHARGED  **
A. PA Sales Tax Exempt - No Form Required
B. PA Sales Tax Exempt with Exemption #
(ex. 75 _ _ _ _ _ _ )
(ex. 76 _ _ _ _ _ _ )
C. PA Sales Tax Exempt - Exemption Form Required
This is one of the following: residence/retail business, retail business, non-charitable organization, campground business, rental property where electric is paid by landlord when rented/vacant
Type your name as you would sign it.
Type your name as you would sign it.
FOR OFFICE USE ONLY
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This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

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32750 Route 6, Wysox PA 18854

Phone: 570-265-2167

Toll-Free: 800-326-9799

Fax: 570-265-6019

Click here for MAP & DIRECTIONS 

41°45'34.0"N 76°21'46.0"W 

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©2022 Claverack Rural Electric Cooperative, Inc. All Rights Reserved.

  • Your Co-op
    • Annual Report/Annual Meeting
    • CEO
    • Claverack Facts
    • Claverack Policies
    • Cooperative Principles
    • Current Bylaws
    • Directors
    • Employees
    • Employment Opportunities
    • History Of Rural Electrification
    • Mission Statement
    • Touchstone Energy Cooperatives
  • Your Home
    • Advanced Metering Infrastructure (AMI) Information
    • Co-op Connections
    • Electric Inspections
    • Generators
    • Member Equipment
    • Meter Tampering Charge
    • New Service
    • Outages
    • Right-of-Way Q&A
    • Service Specs
    • Used Poles
    • 2022 Schedule of Fees
  • Your Bill
    • Update Your Contact Information
    • Gift Certificate
    • Levelized Billing
    • Operation Round-Up
    • Payment Options
    • Time Of Use Rate
    • Security Deposits
    • Together We Save
    • Rates
    • SmartHub 101
    • Your Capital Credits
  • Your Community
    • Distracted Driving Video
    • Dry Hydrants
    • First Responders
    • Penn Lines
    • Safety City (Safety Presentation)
    • Safety Quiz
    • Scholarships
    • Youth Tour
    • Informational Links
  • Your Questions
    • Alternative Energy
      • A Message from Claverack about Alternative Energy
      • Solar Power
      • Windmills
    • Energy Audit
    • Heating Options
    • Power Quality
    • Rates
    • Electric Vehicles
    • Rebate Programs
    • Tree Work and Line Maintenance
  • High Speed Internet News
    • Click Here for the Latest News on Revolution Broadband
    • Revolution Broadband Frequently Asked Questions (FAQ's)
    • Tariff & Regulatory Information