Outage Report Form

Fields that have a star (*) in them are required:

*Your name:
Email:
*Telephone:
*Billing Address:
Service Address (if different):
Location # or Account # (if known):
Name on account (if different from above):
Estimated date and time off:
Known damage:
Other helpful information:
Disclaimer

I understand as the requesting party that I am responsible for this information. I acknowledge that sending Howell-Oregon Electric Cooperative, Inc. an electronic copy of this form releases Howell-Oregon and its agents from expense(s) and/or damage(s) resulting from incorrect information provided herein. I acknowledge that the accuracy and integrity of these forms reflect the service requested herein.

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