REPORT OUTAGE: 800-776-0493

Name Change Application

Name Change Due to Divorce

Capital Credit Application for Name Change Due to Divorce

I hereby request, because of my divorce, that my membership be transferred on the books of Whitewater Valley REMC together with all rights and obligations therewith, to my new legal name.

*Note – If the account is in the name of the ex-spouse, the name on the account can be changed, but any capital credits will remain in the name of the ex-spouse unless the ex-spouse completes another form.  Please fill out the “Form for former spouse to relinquish rights” if this is the case.

Original Name of Member
Original Name of Member
First
Last
New Legal Name
New Legal Name
First
Last
Service Address
Service Address
City
State/Province
Zip/Postal
Mailing Address
Mailing Address
City
State/Province
Zip/Postal
Whitewater Valley REMC Logo

Mailing Address

P.O. Box 349
Liberty, IN 47353


Business Hours

7:30 a.m. - 4:30 p.m.
Monday through Friday


Phone Numbers

765-458-5171 and
800-529-5557

© Whitewater Valley REMC. All Rights Reserved.