GreyStone Power Corporation

Application for Levelized Billing Plan

Thank you for being a member of GreyStone Power. As a convenience to our members we offer levelized billing for non-prepaid qualifying member accounts. To apply for this service, please fill out and submit this form. If you have any questions, call us at (770) 942-6576 or email us at memberservices@greystonepower.com.

*Name on Account:

*GreyStone Account:

*Service Address:

Apt/Unit/Lot:

City:

State:

Zip:

Home Phone Number:

Work Phone Number:

*E-Mail Address:

What is your preferred method of contact if necessary?

*Preferred contact method:

What type of billing do you have?

*Billing Type:

Does this account currently have a zero balance?

Account has a zero balance?:

Accounts with Prepay billing are not eligible for Levelized billing.

Please acknowledge the guidelines for joining this plan:

I am aware my account must not be prepaid to qualify for this plan.

I have been a GreyStone member for more than 12 months and have had no more than two late payments.

To remain on the plan, I know I must pay the full billing amount each month by the due date.

I know once I've been taken off the plan I must wait a year before applying to be in the plan again.

I understand that by submitting this form I am applying for my account to be placed on a levelized billing plan. Acceptance into the plan is based on meeting the criteria listed above.