The undersigned Member of Blue Ridge Electric Membership Corporation hereby requests that Blue Ridge provide to
Blue Ridge Energies the confidential data described below, and consents to the disclosures
of such data.
If the data is being furnished to a subsidiary of Blue Ridge Electric, the member acknowledges that Blue Ridge
Electric has advised that such data will be furnished on a nondiscriminatory basis to any provider of similar
services, whether or not such provider is a subsidiary of Blue Ridge Electric, and that Blue Ridge Electric has
advised that such products and services may be available from other non-subsidiary suppliers at the member’s
request. The Member further acknowledges that if a charge is imposed for such service that the Member will reimburse
Blue Ridge Electric promptly upon being billed for Blue Ridge Electric’s reasonable and customary charges incurred
in connection with assembling, compiling, and furnishing such data (whether the data is furnished to a subsidiary or
non-subsidiary) in accordance with this authorization.
I understand your terms are Net Due-30 days and agree to meet these terms if credit is extended. I agree to pay any
and all finance charges, penalties, or court costs resulting from our account being delinquent. A finance charge of
1 ½% per month, which is an annual percentage rate of 18%, will be added to the remaining unpaid balance
Description of data to be provided: Credit Check-New Customer - Blue Ridge EMC