Credit Card Draft Authorization

Optional: If you would rather download the application and fax or mail it to Santee Electric, please download the pdf document here.

Please fill out this form completely. Uncompleted forms will be discarded.
Fields marked with * are required.

* Name on Account:

* Name on Credit Card:

* Email:

* Credit Card Billing Address:

Apartment / Unit #:

* City:

* State:

* Zip Code:

* Credit Card Type:

* Credit Card Number (no dashes):

* Credit Card Expirate Date:

* Phone Number:

* Your Comments and the best time to call:

By clicking submit on this form your are submitting your electronic signature which is binding in a court of law.

* This is a printer friendly version of the original page, made to save you ink and paper.

Santee Electric Cooperative - Bringing You the Power That You Need

Optional: If you would rather download the application and fax or mail it to Santee Electric, please download the pdf document here.