The undersigned (hereinafter "Customer") (name/names)______________________________________with the mailing address of __________________________________________________________ hereby make(s) application to The CMS Electric Cooperative, Inc., (hereinafter "Cooperative") upon the following terms and conditions for line extension and/or modification at the location described as _______________________.

Membership: Upon execution of this contract and the acceptance by the Board of Trustees of the Cooperative, the undersigned will pay the Cooperative a membership fee of five dollars ($5.00) and will become a member of the Cooperative. As a member of the Cooperative, the Customer shall be bound by the Articles of Incorporation and Bylaws of the Cooperative and Rules and Regulations of the Cooperative as they may be altered or amended from time to time. Customer acknowledges that they have had the opportunity to review these Bylaws and Rules and Regulations (or have received a copy of these Rules and Regulations) and understand that the Bylaws and Rules and Regulations will remain on file at the Cooperative and are subject to review by the Customer during normal business hours.

Service Connection Fee: The Customer shall pay to the Cooperative the sum of twenty-five dollars ($25.00) in cash, which when accepted by the Cooperative shall constitute the payment of one (1) service connection fee.

Right-Of-Way: The Customer agrees to grant the necessary easements and right-of-way over his property free of charge, and will cooperate in the location of poles and guys on his property. The Customer shall own and maintain all poles, wires, equipment, and other facilities beyond the Cooperative's established metering point.

Right Of Access: Duly authorized representatives of the Cooperative, shall be permitted to enter Customer's premises in order to carry out the provisions of this agreement and for the purpose of installing, reading, inspecting or repairing any meters, devices, electric lines and facilities, and other equipment or any purpose incidental to the electric service supplied by the Cooperative.

Rate Of Service: The Customer will, when electric energy becomes available, pay the Cooperative for electric service at the rate provided in the applicable rate schedule and in accordance with the terms and conditions contained in the Cooperative's Rules and Regulations. The Customer expressly agrees and understands that all charges and adjustments thereto provided for in the applicable tariff shall be subject to change by the Cooperative in accordance with applicable laws, rules, and regulations governing the Cooperative.

Line Extension And Modification Cost: The Customer shall pay to the Cooperative the line extension and/or the modification costs, in addition to the membership fee, service connection fee, and the electric service rate. Such costs are estimated to be $_________, and shall be paid in accordance with the Cooperative's Rules and Regulations.

Term: This agreement shall become effective on the date service is first made available hereunder by the Cooperative to the Customer, and shall remain in effect not less than _________months or thereafter until canceled by written notice given by either party to the other.

Succession: This agreement shall be binding and inure to the benefit of the successors, legal representatives, heirs, devisees and assigns of the respective parties.

Security Deposit: The Customer may be required to provide credit information and/or make a security deposit with the Cooperative in accordance with the Cooperative's rules and regulations governing such deposits and refunds, if any.