Roanoke Electric Cooperative

Request for Unclaimed Capital Credits

Please submit this form to determine if you have unclaimed capital credits. Please provide a copy of your valid Driver's License or other Photo ID. Instructions for providing a photo ID can be found at the bottom of the form.

If you have questions, please contact our Capital Credits representative at 800-433-2236 or 252-209-2236 .

*Name:
Member Number:
*Date of Birth:
*Last 4 digits of SSN:
*Home Phone Number:
Work Phone Number:
Cell Phone Number:
How many years of Service with Roanoke Electric?
*Years of Service:

Service Address:

*Street Address:
Mailing Address:
*City:
State:
*Zip:

Current Address:

*Street Address:
Mailing Address:
*City:
State:
*Zip:

Instructions for submitting additional documents:

There are five methods available for submitting additional documentation. Method 1: Electronic File Upload You can upload an image or PDF using the file upload tool, below. The file can be up to 10 MB in size and must be one of the following file types: PDF JPG JPEG PNG GIF ZIP. If you have multiple files, you can combine them into one zip file (using your zip software) and attach the zip file to this application with the file upload tool.
Attach Document:
Method 2: Fax Fax copies of pictures and paper documents to the fax number below. Method 3: Electronic Mail After submitting this online application, you will receive a confirmation email. By replying to this email you can submit electronic copies of scanned images and PDFs by attaching them. Use the personalized subject provided to ensure your documents get delivered to the right place. Method 4: Online Upload Tool After you submit the online application, you can provide additional materials by using our online document upload tool. You will receive more information about the upload tool after the application is submitted. Method 5: Postal Mail Mail copies of pictures and paper documents to the address below.
Roanoke Electric Cooperative P.O. Box 1326 Ahoskie, NC 27910 Phone: 252-209-2236 Fax: 252-209-5055