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-QUAD CONSTRUCTIONJ. & J. ENTERPRISESJ. CLYDE MITCHELL FARMJ. D. ALLEN RIVER HOUSJ. E. PARRISH POND HOUSEJ. H. MORRIS BUILDINGS SUPPLYJ. W. MORTON MERCHANDISEJACKSON AMYJACKSON ANNIE CJACKSON ANNIE LJACKSON BERNARD R.JACKSON BETHJACKSON BOBBY LJACKSON CHARLES EJACKSON CHARLES FJACKSON CLAYJACKSON DAUGHTYJACKSON EMILY FJACKSON EULIEJACKSON GEORGE TJACKSON HARRYJACKSON HOMERJACKSON J.JACKSON JAMESJACKSON JAMES A JRJACKSON JAMES LJACKSON JAMES M.JACKSON JEFFERY SJACKSON JESSIE A.JACKSON JOSEPHJACKSON KENNETHJACKSON LARRYJACKSON LEON E.JACKSON LUEVENNIAJACKSON MAMIEJACKSON MARSHAJACKSON OSCAR DR. JR.JACKSON OSCAR JR.JACKSON PAULA S.JACKSON R SUSANJACKSON RAY SJRJACKSON RICARDOJACKSON SANDRAJACKSON SHERRYJACKSON T LJACKSON TUNISAJACKSON VELVETJACKSON VERNON JR.JACKSON WILLIE LJACOBS MARK O.JAMES ALEXJAMES BARBARAJAMES DONALDJAMES GARY WIIJAMES GERTRUDEJAMES GULF STATIONJAMES MARIEJAMES P. MJAMES STEPHEN LJANCOWSKI ALAN R.JARRELL BENJARRIEL BENJAMIN WJARRIEL JEFFJARVIS DAVIDJARVIS DAVID PJAUDON RACHAELJEAN ALDRICHJEFFERS DERRICKJEFFERSON DEXTERJEFFERSON GAILJEFFRIES RICHARD L.JENIK JOHNJENKIN W GRADYJENKINS ALBERTAJENKINS ALLENJENKINS BARBARA LJENKINS BETTYJENKINS BETTYJENKINS COUNTY HOSPITALJENKINS DANIEL RJRJENKINS DWAYNEJENKINS FARON EJENKINS FRANKLINJENKINS GARY LJENKINS HAROLDJENKINS J MJENKINS JACQUITA J.JENKINS JIMMYJENKINS LEEJENKINS LOUISEJENKINS MAMIEJENKINS MARTHA H.JENKINS NELLIE FJENKINS PEGGY TJENKINS PRATHELJENKINS RJENKINS RANDYJENKINS RAYMONDJENKINS SERVICE STATIONJENKINS SHIRLEYJENKINS TALMADGEJENKINS TYIA LJENNINGS CONSTRUCTION - PAGERJENNINGS JONEY MJENNINGS MRS. PAULJENSEN LARRY G.JENSEN THOMAS LJERNIGAN HARRY J.JERNIGAN ROBERT FJR.JERRY'S BACKHOE SERVICEJERRY'S SOC. STATIONJERVIS B. WEBB CO. OF GA.JESSE GROOMS GARAGEJESSE'S CONSTR & REMODELINGJEWELL JASONJIM'S GULF SERVICEJIMENEZ FELIPEJIMENEZ FRANCISCAJIMMY WARDS ELECTRONICSJOBE HOWARDJODIES SEAFOODJOE COLLINSJOE GROOMS BODY SHOPJOHN F. COLLINS CLUB HOUSEJOHN P WALSH CONST & FABJOHN'S CAR CLEAN-UPJOHN'S COUNTRY STOREJOHN'S COUNTRY STORE PAY STA.JOHNS BOBBYJOHNS ERNESTINE MJOHNS JOEJOHNS KENNETH EJOHNS LARRYJOHNS WALTER RJOHNSON ADAJOHNSON ADA DJOHNSON ALETHEIAJOHNSON AMYJOHNSON AUDREY MJOHNSON BARBARAJOHNSON BOBBYJOHNSON BRUCE EJOHNSON CAROLYNJOHNSON CATHI LJOHNSON CHESTER EIIJOHNSON CLIFFORDJOHNSON DANIEL LJOHNSON DANNY KJOHNSON DARONJOHNSON DAVID AJRJOHNSON DEREKJOHNSON DONALDJOHNSON DOVIEJOHNSON EDDIEJOHNSON EMMA JEANJOHNSON EUGENEJOHNSON GARYJOHNSON GEORGEJOHNSON GRADY E.JOHNSON HERMANJOHNSON HERMAN JR.JOHNSON INEZJOHNSON INSURANCE AGENCYJOHNSON J CJOHNSON J. W.JOHNSON JAMESJOHNSON JAMES JR.JOHNSON JAMES RJR.JOHNSON JEANNE DJOHNSON JEFFJOHNSON JENNIFERJOHNSON JERRY W.JOHNSON JESSIE EJOHNSON JOHN W.JOHNSON JOHNNYJOHNSON JOY MJOHNSON JUNIORJOHNSON KENNETH IJOHNSON KENNETH PAGER -JOHNSON KIMBERLYJOHNSON KIMBERLY MJOHNSON L. D.JOHNSON LARRY PJOHNSON LEE HJOHNSON LINDAJOHNSON LINDA KJOHNSON LISEJOHNSON LYNNJOHNSON LYNSEYJOHNSON MARCIAJOHNSON MARIEJOHNSON MARYJOHNSON MARY LJOHNSON MARY MRS.JOHNSON MELONEJOHNSON MRS. WAYNEJOHNSON PAUL DJOHNSON PHYLLIS TJOHNSON POLLYJOHNSON POLLY BJOHNSON PRESTON H.JOHNSON RAYJOHNSON RICHARD B.JOHNSON RICHARD MJOHNSON ROBERT E.JOHNSON ROBERT WJOHNSON RONALDJOHNSON RONDA MJOHNSON RONNIEJOHNSON ROSALINDJOHNSON S. S. PAY STATIONJOHNSON SALLY MJOHNSON SAMMIE LJOHNSON SHANNONJOHNSON SHEILAJOHNSON SHIRLEYJOHNSON SHIRLEY LJOHNSON SUEJOHNSON THEOLAJOHNSON VIOLAJOHNSON WILLIAM EJOHNSON WILLIAM FJOHNSON WILLIAM R.JOHNSON WILLIE MJOHNSON WILSONJOHNSON'S BACKHOE SERVICEJOHNSON'S CAFEJOHNSON'S SANITATION SERVICE IJOHNSTON ANNAJOHNSTON GEOJOHNSTON JACK W.JOHNSTON JOE P BARNJOHNSTON JOE P RIVERHOUSEJOHNSTON KRUGER EJOINER ALJOINER ALANJOINER CHARLESJOINER DEBBIE D.JOINER HERBERTJOINER J.B.JOINER JASPER H.JOINER JENNIFERJOINER LEOJOINER MELANIEJOINER TRACIJOLLY JOE'SJOLLY JOE'S SPEAK EZYJOMAX COUNTRY STOREJONAS RICKJONES (DECEASED) HARRYJONES ALICIA JJONES ANNETTE BJONES BENJAMIN CJONES BEVERLYJONES BEVERLY SJONES BILLIEJONES BOB EJONES BOBBYJONES BRETT RJONES BROS.JONES BUILDING SUPPLYJONES C C IIIJONES C SJONES CAPT JESSIE MJONES CATHYJONES CLUISEJONES CYNTHIA HJONES DAISYJONES DANJONES DANIEL FJONES DARRYLJONES DEBRA LJONES DEVORAHJONES DORETHAJONES DOUGJONES DOUGLASJONES DOUGLAS JRJONES DOYLE EJONES EARL WJONES EARNESTJONES EDDIE BJONES ELOISJONES ELOISEJONES ERNESTJONES EULA MAEJONES EUNICE LEEJONES FERMON M JRJONES GEORGE B JRJONES GEORGE WJONES GORDONJONES H PJONES HAROLD GJONES HELEN BJONES HENRY TJONES IVA LJONES J PJONES JACQUELYNJONES JAMESJONES JAMES RIIIJONES JOHN W.JONES JOHNNYJONES JULIAJONES KAY MRS.JONES KELVINJONES LANE COMPANYJONES LEE REVJONES LESLIE DJONES LISAJONES LIZZIEJONES LLOYD MJONES LONNIE F.JONES LORETTAJONES LORIJONES LOUISEJONES LUETRELLJONES MAEJONES MARCIA IJONES MARIEJONES MARSHALL JJONES MARTIN DJONES MRS. J. M. D.JONES RANDYJONES RAY LJONES REATHER CJONES REV S LJONES RICHARDJONES ROBERT AJONES ROBERT A.JONES ROBERT LJR.JONES RONELLAJONES ROSE BUDJONES SAV-A-DOLLARJONES SHIRLEYJONES SHIRLEY AJONES STEVENJONES TERRYJONES TOMJONES TOMMYJONES TOMMY SRJONES TRACEYJONES TROY L.JONES UDELLJONES UNION 76 STATIONJONES VIRGINIAJONES W K LUMBER COJONES W. JARELLJONES W. W.JONES WALDOJONES WANDAJONES ZERA L.JONES ZULENEJONES, W. K. LUMBER CO.JORDAN ALISON DJORDAN CHARLIE WJORDAN EUGENEJORDAN JAMES RJORDAN JULIEJORDAN KELVIN WJORDAN LISAJORDAN LISA MISSJORDAN MARION JRJORDAN RALPHJORDAN SHIRLEYJORDON GARY BSRJOSEY R GJOSTEN LEARNING CORPJOUCE RICKYJOYCE ERNEST JR.JOYCE MARGARITEJOYNER BEN LJOYNER CHESTERJOYNER CRAIGJOYNER J LJOYNER JAMES DJOYNER MINNIE BJOYNER REV JOHNJOYNER SCOTTJOYNER SIDING COMPANYJRS HGM TOWINGJUNOT PAT BULLOCH 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: 128 MB. Is there anything else you'd like to tell us?
