Capital Credits # A B C D E F G H I J K L M N O P Q R S T U V W Y Z J & J TRUCKINGJ W CONSTRUCTIONJ W CONSTRUCTIONJ. CLYDE MITCHELL FARMJ. D. ALLEN RIVER HOUSJ. E. PARRISH POND HOUSEJ. H. MORRIS BUILDINGS SUPPLYJ. W. MORTON MERCHANDISEJACKSON BOBBIE JJACKSON CHARLES E.JACKSON HARRYJACKSON JAMES MR. & MRS.JACKSON JEFFERY S.JACKSON MAMIEJACKSON MARSHAJACKSON SANDRAJACKSON VERNON JR.JACKSON, AMYJACKSON, AMYJACKSON, BERNARD R.JACKSON, BETHJACKSON, BETHJACKSON, BETHJACKSON, CAROLYNJACKSON, DAUGHTYJACKSON, DAUGHTYJACKSON, DAUGHTYJACKSON, EULIEJACKSON, HOMERJACKSON, JAMES A., JR.JACKSON, JAMES M.JACKSON, JOHN L. DR. LAKEHOUSEJACKSON, JOSEPHJACKSON, LARRYJACKSON, LEON E.JACKSON, LUEVENNIAJACKSON, OSCAR JR.JACKSON, PAULA S.JACOBS, MARK O.JAMES GULF STATIONJAMES P. MICHAELJAMES STEPHEN L.JAMES, ALEXJAMES, GERTRUDEJAMES, MARIEJANCOWSKI, ALAN R.JARRIEL BENJAMIN WALTERJARRIEL, JEFFJARVIS DAVID P. & CAROL A.JEAN ALDRICHJEFFERSON, GAILJENIK, JOHNJENKIN W GRADYJENKINS ALLENJENKINS B RJENKINS BENNY NORMANJENKINS BETTYJENKINS COUNTY HOSPITALJENKINS DANIEL RAYJENKINS FARON E.JENKINS FRANKLINJENKINS FRANKLINJENKINS J MJENKINS MAMIEJENKINS P. T.JENKINS PRATHELJENKINS SERVICE STATIONJENKINS SHIRLEYJENKINS TOMMYJENKINS TYIA LJENKINS, ALBERTAJENKINS, BETTYJENKINS, BETTYJENKINS, DWAYNEJENKINS, JACQUITA J.JENKINS, JIMMYJENKINS, LOUISEJENKINS, MARTHA H.JENKINS, PRATHELJENKINS, RANDYJENKINS, RAYMONDJENKINS, RAYMONDJENKINS, TALMADGEJENNINGS, JONEY M & BRIANJENNINGS, MRS. PAULJENSEN, LARRY G.JERNIGAN ROBERT F. JR.JERNIGAN, HARRY J.JERRY'S BACKHOE SERVICEJERRY'S BACKHOE SERVICEJERRY'S BACKHOE SERVICEJERRY'S SOC. STATIONJERVIS B. WEBB CO. OF GA.JESSE GROOMS GARAGEJEWELL JASONJEWELL JASONJHOCSON ANTONIO L MDJIM'S GULF SERVICEJIMMY WARDS ELECTRONICSJODIES SEAFOODJOE GROOMS BODY SHOPJOHN F. COLLINS CLUB HOUSEJOHN P WALSH CONST & FABJOHN'S CAR CLEAN-UPJOHN'S COUNTRY STOREJOHN'S COUNTRY STORE PAY STA.JOHN'S COUNTRY STORE PAY STA.JOHNS ERNESTINE MJOHNS JOEJOHNS KENNETH E.JOHNS ROCKYJOHNS, LARRYJOHNSON AUDREY M.JOHNSON BARBARAJOHNSON CLIFFORDJOHNSON DANIEL L.JOHNSON DANNY K.JOHNSON DOVIEJOHNSON EMMA JEANJOHNSON GARYJOHNSON HERMAN JR.JOHNSON INSURANCE AGENCYJOHNSON INSURANCE AGENCYJOHNSON J CJOHNSON JAMES R JR.JOHNSON JEANETTEJOHNSON JOY M.JOHNSON KENNETH I.JOHNSON LYNSEYJOHNSON MARYJOHNSON MARY L.JOHNSON OLLIE MAEJOHNSON RICHARD MJOHNSON S. S. PAY STATIONJOHNSON S. S. PAY STATIONJOHNSON SHIRLEY LJOHNSON WILLIAM F.JOHNSON, ADAJOHNSON, ADAJOHNSON, ADAJOHNSON, BARBARAJOHNSON, BOBBYJOHNSON, CAROLYNJOHNSON, CAROLYNJOHNSON, CAROLYNJOHNSON, DARONJOHNSON, EDDIEJOHNSON, EUGENEJOHNSON, EUGENEJOHNSON, GEORGEJOHNSON, GRADY E.JOHNSON, HERMANJOHNSON, J. W.JOHNSON, JAMES JR.JOHNSON, JERRY W.JOHNSON, JOHN W.JOHNSON, JOHNNYJOHNSON, JUNIORJOHNSON, KIMBERLYJOHNSON, L. D.JOHNSON, L. D.JOHNSON, MARCIAJOHNSON, MARIEJOHNSON, MARY MRS.JOHNSON, MRS. WAYNEJOHNSON, POLLYJOHNSON, PRESTON H.JOHNSON, RICHARD B.JOHNSON, RICHARD B.JOHNSON, ROBERT E.JOHNSON, ROBERT W.JOHNSON, RONALDJOHNSON, RONNIEJOHNSON, SHIRLEYJOHNSON, SUEJOHNSON, THEOLAJOHNSON, VIOLAJOHNSON, VIOLAJOHNSON, WILLIAM R.JOHNSON, WILSONJOHNSON'S BACKHOE SERVICEJOHNSON'S CAFEJOHNSTON JOE P BARNJOHNSTON JOE P RIVERHOUSEJOHNSTON KRUGER EJOHNSTON, ANNAJOHNSTON, GEO. - ATTY.JOHNSTON, JACK W.JOINER DALE MJOINER JENNIFERJOINER JERRYJOINER TRACIJOINER, ALJOINER, CHARLESJOINER, DEBBIE D.JOINER, HERBERTJOINER, J.B.JOINER, JASPER H.JOINER, MELANIEJOINER, MELANIEJOLLY JOE'SJOMAX COUNTRY STOREJONES (DECEASED) HARRYJONES ALICIA JJONES BELINDAJONES BELINDAJONES BENJAMIN CJONES BEVERLYJONES BILLIEJONES BILLIEJONES BOBBYJONES BROS.JONES BUILDING SUPPLYJONES BUILDING SUPPLYJONES C C IIIJONES C SJONES CAPT JESSIE MJONES CATHYJONES CYNTHIA HAGINSJONES CYRILJONES DAISYJONES DANJONES DARRYLJONES DEVORAHJONES DOUGJONES DOUGLASJONES DOUGLASJONES DOUGLASJONES DOYLE EJONES EARNESTJONES EDDIE BJONES ELOISJONES ELOISJONES ELOISEJONES ERNESTJONES EULA MAEJONES EUNICE LEEJONES FERMON M JRJONES GEORGE B JRJONES GORDONJONES H PJONES HELEN BJONES HENRY TJONES IVA LJONES J PJONES JOHN HENRYJONES JULIAJONES LANE COMPANYJONES LARRY RJONES LEE REV & MARYJONES LESLIE DJONES LIZZIEJONES M. I.JONES MARTIN D (MARK)JONES REV S LJONES ROBERT L. JR.JONES SAV-A-DOLLARJONES TOMJONES UNION 76 STATIONJONES W K LUMBER COJONES W K LUMBER COJONES, JACQUELYNJONES, JAMESJONES, JAMES H. & ELLENJONES, JOHN W.JONES, JOHN W.JONES, KAY MRS.JONES, LONNIE F.JONES, LORETTAJONES, LORIJONES, LOUISEJONES, LOUISEJONES, LUETRELLJONES, LUETRELLJONES, MAEJONES, MARIEJONES, MRS. J. M. D.JONES, RANDYJONES, RICHARDJONES, ROBERT A.JONES, RONELLAJONES, ROSE BUDJONES, TERRYJONES, TOMJONES, TOMMYJONES, TROY L.JONES, TROY L.JONES, TROY L.JONES, VIRGINIAJONES, W. JARELLJONES, W. K. LUMBER CO.JONES, W. W.JONES, WALDOJONES, WANDA & RODNEYJONES, ZERA L.JONES, ZULENEJORDAN EUGENEJORDAN JAMES RJORDAN LISA MISSJORDAN MARION JRJORDAN RALPHJORDON, GARY B., SR.JOUCE, RICKYJOYCE, ERNEST JR.JOYCE, ERNEST JR.JOYCE, MARGARITEJOYNER BEN LJOYNER CHESTERJOYNER CRAIGJOYNER CRAIGJOYNER ELLAJOYNER J LJOYNER JAMES DANIELJOYNER JOHNNIE RJOYNER MINNIE BJOYNER SCOTTJOYNER SIDING COMPANYJOYNER SIDING COMPANYJUNOT, PATBULLOCH TELEPHONE COOPERATIVE CLAIM FORM Existing Member Name(Required) First Last Existing Street Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Updated Name(Required) First Last Updated Street Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Account NumberMember NumberPhone NumberIn conjunction with the retirement of capital credits prior to 1990, I hereby make the following certification regarding my status or my entities status prior to receiving our patronage refund: I am a residential customer and have not deducted the cost of communication service on any tax return for the years prior to 1990. The qualified Member above is deceased and I am claiming the Patronage refund on their behalf. I have included a death certificate and a court document to verify that I am qualified to receive the refund and will distribute the proceeds according to the laws of Georgia. My entity is incorporated under the corporate laws of Georgia and our state issued control number below.Control NumberFile UploadMax. file size: 50 MB.Is there anything else you'd like to tell us?
