UNCLAIMED CAPITAL CREDITS For the Years 1984,1985, 1986, and 1987 The following is a list of capital credit checks returned to the cooperative, marked unknown or undeliverable. If the name of a deceased person is listed, the spouse, child, or the executor or administrator may be entitled to the refund. In order to receive a deceased member’s capital credits, the “Deceased Member Form” will need to be filled out completely, notarized and returned to our office. INSTRUCTIONS FOR CLAIMING CAPITAL CREDITS 1. Definition of capital credits: Margins (dividends) are distributed to each membership based on the total amount paid for power bills during the calendar year. 2. To claim the capital credits of a deceased member you MUST fall into one of the following groups. a. The executor of the estate or the administrator of the will. b. The spouse. c. The surviving child. 3. You are not entitled to capital credits of the following: grandparents, aunts, uncles or cousins. 4. The “Deceased Member” form MUST be filled out completely, signed and NOTARIZED. Make sure a contact telephone is included so you can be reached during the day, if needed. 1 P.O. BOX 681570 PRATTVILLE, ALABAMA 36068-1570 1. Name of Member: _______________________________________________________________________________________________ 2. Account(s): ___________________________________________________________________________________________________ 3. You must meet one of the following requirements to be entitled for Capital Credit payments. a.) Administrator Name: _________________________________________________________________________________________ Address: _______________________________________________________________________________________________ Date of Appointment: ________________________________________________________________________________________ Court: _________________________________________________________________________________________________ b.) Last Surviving Spouse’s Name: ___________________________________________________________________________________ Address: _______________________________________________________________________________________________ c.) Surviving Child’s Name: _____________________________________ Age: ______________ Address: _______________________________________________________________________________________________ ____________________________________________________________________________________________________ (To my knowledge the estate of the deceased had no will, no executor or administrator, and no spouse surviving the deceased. I understand that if I am not entitled to these Capital Credits, I may be prosecuted for perjury and subject to penalty under the law with the State of Alabama.) 4. Your Telephone Number : ________________________________ 5. Service Address: ________________________________________________________________________________________________ (Where the deceased member lived during the refund years) APPLICATION FOR CAPITAL CREDITS Application is hereby made to Central Alabama Electric Cooperative, hereinafter called the Co-op, to pay the capital credits for the years _______________ , of the above named deceased member, less any sum of debt owed by him/her to the Co-op. Applicant represents that he/she is over the age of 21 years: the aforesaid facts entitle him/her to such payments under the bylaws, rules, regulations and policies of the Co-op; and that the above representations were made for the express purposes of inducing the Co-op to make such payments to this applicant. IN CONSIDERATION of the payment of the aforesaid, receipt of which is hereby acknowledged. I bind myself, my heirs, executors and administrators to protect and save harmless and fully indemnify the Co-op against any damage, claim or expense arising out of the payment of said sums to me. I agree to pay all costs of enforcing this obligation, including a reasonable attorney’s fee, and I waive as to this obligation all right of exemption as to personal property under the constitution and statues of this and any other state. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the ______day of _____________________ , 20 ____ . ______________________________________________________________________________Applicant The aforesaid applicant, being by me first duly sworn, an oath that the facts stated in the foregoing QUESTIONNAIRE and APPLICATION are true and correct and subscribed his/her name in my presence. IN WITNESS THEREOF this _______ day of ________________________, 20 ____. (SEAL) Notary Public ________________________________ 2 Unclaimed Capital Credits for 1984,1985, 1986, and 1987 If you have questions, please call (334) 351-2122. Account # Account # Account # Account # Account # A ALABAMA POWER CO 7752000 ANDREWS GAIL D 9486500 ATHEY C S 2339300 BAKANE LOUIS KELLEY 10594700 A T & T COMMUNICATIONS 2111100 ALABAMA POWER CO 8113300 ANDREWS GARY A 10956800 ATKINS SANDRA FAYE 10509800 BAKER AGNES 7969100 AAA BLDRS,JOSEPH ALDREDGE JACK 6140700 ANDREWS HELEN M 10726000 ATKINS SHERRY C 9856900 BAKER ANNIE J 9250700 HAPONSKI JR 2459100 ALDRIDGE CHARLES ROBERT 9641500 ANDREWS J C 2581300 ATKINSON HUGH L 8933700 BAKER CLARENCE LEE 8927200 ABBOTT ALSIE M 3458000 ALEXANDER CAPUS JR 6344900 ANDREWS J C 2820100 ATKINSON HUGH L 9100500 BAKER CLARENCE W 4051600 ABERNATHY JEWEL 3226700 ALEXANDER DELORES 3093200 ANDREWS JOHN WILLIAM 9790000 ATKINSON J P 75800 BAKER CLYDE M 3872000 ABRAMS AUBREY L 9576200 ALEXANDER EMMA L 2495200 ANDREWS MARTHA JUNE 10795100 ATKINSON SHIRLEY 9669900 BAKER DARRELL 1544900 ABRAMS C C 6224100 ALEXANDER JOHN H 10157600 ANDREWS RICKY L 10614600 ATTAWAY BILLY J 7737800 BAKER DARRELL 10825700 ABRAMS J M 103100 ALEXANDER JUDY 10794400 ANDRUSKY RONALD G MRS 10136100 AUSBUN JOHN B 3563300 BAKER GWYNN C 10683700 ABRAMS LOIS 9180200 ALEXANDER LAFAYETTE 7894800 ANGLE JAMES ROBERT 9165500 AUSTIN ADAM 9059000 BAKER HELEN M 9768300 ABSHER F J 3796900 ALEXANDER RENA B 10314800 ANNIE B CHESSER 3110600 AUSTIN ALICE 10344000 BAKER ISAAC D 9255800 ABSHER ROGER D 9587300 ALFORD RALPH 750500 ANNIS JAMES E 10171100 AUSTIN MARY G 9555600 BAKER J J 8218500 ABSHIER ANNIE LOU 7868300 ALFORD WINFORD O 2956600 ANSARI ALFONSO ATIF A 10097800 AUSTIN MARY NELL 10513800 BAKER J L 4110300 ACOFF MARY E 10430600 ALLEGOOD R M 3728200 ANTHONY BERNICE 3238700 AUSTIN OLIVER DONNIE 10304100 BAKER JAMES A 5083300 ACREMAN L H 8383300 ALLEN CALVIN T 9263300 ANTHONY CONNIE SUE 9604400 AUSTIN ROOSEVELT 2676400 BAKER JEANETTE 4037700 ACREMAN WAYNE 9526000 ALLEN CHARLES 2799100 ANTHONY EDNA F 10827600 AUSTIN W O 10774900 BAKER JIMMY J 10220900 ACUFF ROY E 10901800 ALLEN CHARLES MRS 1710100 ANTHONY RICHARD 4263500 AUTAUGA CO BD OF REV 578600 BAKER JOEL D 10106300 ADAIR BENNIE W 4196900 ALLEN DAVID G JR 9740200 ARANT MARTIN L 1757800 AUTAUGA CO BD OF REV 4757500 BAKER KAREN W 10621200 ADAIR CLIFTON WAYNE 9855900 ALLEN JANIE 5016700 ARCHIE EDGAR L 2534100 AVARY JAMES L 10960800 BAKER LENA 2974100 ADAIR J E 3550900 ALLEN JERRY R MRS 10761200 ARMISTEAD CLARA P 1976400 AVERETTE H K 3211900 BAKER LIZZIE L 6012500 ADAIR M L 4039300 ALLEN JIMMY L 9665400 ARMS JACOB E 9689400 AVERHART VANDARREN 10341100 BAKER MARGIE M 9344000 ADAIR WILLIAM H 1583300 ALLEN JOYCE M 9707400 ARMSTRONG ANNIE 9864200 AVERI ROBERT 11196700 BAKER OSCAR 5090000 ADAMS BIFFLE L 8176600 ALLEN LEVI L 3303100 ARMSTRONG JAMES R 10660700 AVERY DANNY LEE 10550800 BAKER WADE 703100 ADAMS EDGAR EUGENE 10783200 ALLEN LUCILLE M 9259200 ARMSTRONG LONZO MRS 8922500 AVERY LOUISE 6013300 BAKER WILLIAM F 9262000 ADAMS GERALD C 10103900 ALLEN MARVIN E 10293200 ARMSTRONG ROY DOUGLASS 9352000 AVONDALE MILLS 2538400 BALDWIN EVELYN 9420500 ADAMS GUY T 5022900 ALLEN RICHARD E 10501600 ARMSTRONG STEVEN J 10548900 AVONDALE MILLS 3860400 BALLARD JAMES E 3590500 ADAMS HOWARDINE 3729700 ALLEN THOMAS W 9553600 ARNOLD ALICE O 316000 AVONDALE MILLS 3860500 BALLINGER RAY T 10959700 ADAMS JAMES A 10074700 ALLEN W L 7768500 ARNOLD ALICE O 9520000 AVONDALE MILLS 3860600 BALLOU LEON 10469100 ADAMS JEFF 2442200 ALLISON GEORGIA A 9686700 ARNOLD H A 8344400 B BALTZELL CHARLES W 1542000 ADAMS JOHN W 1718300 ALSOBROOK LAWRENCE C 2118100 ARNOLD MICHAEL K 9601400 BABSTON TED B 218500 BAMA WOOD INC 2595400 ADAMS JOHN W 2677800 ALSOBROOK MELBA W 2363100 ARRINGTON SADIE M 8162600 BAGGETT JAMES A 10679200 BAMBERG CECIL C 10307500 ADAMS JOYCE B 10842400 AMASON THOMAS M 10503000 ARTHUR JUDSON V 7790000 BAIDY ALGIE 6108200 BAMBERG CHESTER L 8906100 ADAMS LEONA 8660900 AMAZING GRACE BAP CHURCH ASH TOMMY L 8696100 BAILEY CHARLES AUBREY 9547400 BANDI REECE 10286200 ADAMS MILLARD 8032100 10418900 ASHBURN VIRGINIA R 10623300 BAILEY ESSIE F 4120100 BANKS KENNETH 10811100 ADAMS MILLARD 8192900 AMAZING GRACE INDEP BAPT 9988400 ASHCRAFT CATHY 10373200 BAILEY EVA MRS 10066600 BANNISTER ELAINE G 10498100 ADAMS RANDALL K 10706000 AMERIGAS 3399600 ASHCRAFT JAMES M 10471300 BAILEY FAIT 9892100 BARBER ANNETTE 10553100 ADAMS ROBERT 8923800 AMES CYNTHIA LEE 10718000 ASHLEY ANNIE LOIS 9475600 BAILEY FAIT MRS 9826000 BARBER M O 1101000 ADAMS STANLEY NEAL 9648500 ANDERSON ANGI DENEICE 10192400 ASHLEY DAVE ANNA 7707000 BAILEY FAIT MRS 10293300 BARBER M O 8364900 ADAMS VIRGIL 9784900 ANDERSON BYRON 10122200 ASHLEY HERBERT 2745900 BAILEY FAIT MRS 10487700 BARBOUR ROBBIN S 9943300 ADAMS WILLIAM CURTIS 10031600 ANDERSON CLAYTON 3590100 ASHMORE JOHN A 3402200 BAILEY JEFF 10547500 BARCLAY DON R 8117700 ADAMS WILLIAM M MRS 9962200 ANDERSON DAN 3728900 ASHWORTH LOUIE DAVID 10727900 BAILEY LILAR 8157500 BARFIELD CARLA SELLERS 10020100 ADAMSON