Form Rct-126 - Membership Report For Use By Electric Co-Operative Corporations 2006 Report Page 2
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1
2RCT-126
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Page 2
Address of the Corporation’s principal office is
(
)
STREET ADDRESS
(CITY)
(STATE)
(ZIP CODE)
1. Did the corporation provide retail electric services outside its certified territory during the tax period covered by this
report.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
2. If yes, what were the gross receipts from retail electric services provided in Pennsylvania outside the corporation’s
certified territory during this tax period?
$
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
OFFICERS OF THE CORPORATION
NAME
TITLE
HOME STREET ADDRESS
CITY
STATE
ZIP CODE
NAME
TITLE
HOME STREET ADDRESS
CITY
STATE
ZIP CODE
NAME
TITLE
HOME STREET ADDRESS
CITY
STATE
ZIP CODE
NAME
TITLE
HOME STREET ADDRESS
CITY
STATE
ZIP CODE
NAME
TITLE
HOME STREET ADDRESS
CITY
STATE
ZIP CODE
On the 31st day of December, 2006
Number of Members in the Corporation Totaled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fee of Ten Dollars for each One Hundred Members or fraction thereof (Enter this amount on Page 1, Column A) . . . . . . . .
$
(Whole Dollars Only)
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