InstagramThis field is for validation purposes and should be left unchanged.Name First Last Please provide a brief description of your issue:(Required)Service address where the issue is located:(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Natchez Trace EPA Account Number(Required)6 digits followed by a dash, then another 6 digits. In example: 222222 - 1111111(Required) At its discretion, Natchez Trace EPA may remedy the issue stated above if it deems that the problem does create a significant threat to the coop’s distribution network.(Required)2(Required) Issues that don’t require an immediate resolution may be handled by our ROW crew as part of their normal ROW clearing process. Full system rotations take the ROW crew 5 to 6 years to typically complete. It is understood that my request may not be resolved until the ROW crew returns to the address listed above.(Required)3 Should we not be able to remedy the situation listed above in a timeframe that suits the member, we may at our convenience temporarily remove our distribution lines at your request so this action can be taken by yourself or another party.Consent(Required) I am the property owner and a legal adult.(Required)4(Required) I acknowledge and accept that it is my responsibility to clean up the tree(s) or other vegetation which the Association cuts pursuant to my request.(Required)Consent(Required) I do hereby release and discharge the Association and its employees from any and all claims, demands, grievances, causes of actions of every kind whatsoever including, but without limitations, all liabilities for damages of any kind, nature or description which may arise from or out of damages or injuries, permanent or otherwise, which may result from the Association’s felling of the tree(s) or parts of tree(s) on my property.(Required)Member Consent(Required) I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Member Signature (Full Name)(Required)
