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 O. A. HALL - SERV. STA.O'BERRY FRED BO'BRIEN PAULO'CAIN SARAH B.O'CAIN STEVEO'DONNELL BOBO'DONNELL GRACIEO'NEAL JAMESO'NEAL REGINAO'QUINN RONOAK GROVE BAPT. CH PASTOAKES RALPH C.OBERSHAN MIKE COBROFTA ALBERT L.ODOM BEATRICE CODOM BEN G. DR.ODOM GERIODOM M MODOM MARCODOM TIMODUM BEN G. DR.ODUM JERRYOGEECHEE BEER & WINE SHOPOGEECHEE CLINICOGEECHEE CONCRETE SERVICESOGEECHEE HUNTING CLUBOGEECHEE SCH NAT'L BROAD CO.OGLE DARRELL H.OGLESBY BELLEOGLESBY BRENDAOGLESBY BURNETTE W.OGLESBY CHARLES L. JROGLESBY CLINTONOGLESBY HUGH D.OGLESBY KEITHOGLESBY KELVINOGLESBY KENNYOGLESBY LORRAINE MRS.OGLESBY MERLEOGLESBY O COGLESBY OTIS JROGLESBY PRISCILLAOGLESBY PRISCILLA DOGLESBY RONNIEOGLESBY W. A.OK GARAGEOLER LINDSEYOLIVE BRANCH BAPT. PAST.OLIVE BRANCH PASTORIUMOLIVE ESTELLEOLIVER BARNEYOLIVER ELIZABETHOLIVER ERICKAOLIVER PEGGYOLLIFF BOBBY J.OLLIFF DORISOLLIFF JOHN H.OLLIFF JOHNNY ROLLIFF MRS. LORAINEOLLIFF R. E.OLLIFF WAYNEOLLIFF WAYNE R. JR.OLLINGER JIMOLSEN SIGRIDOLSEN SIGRID D.OLSON DAVIDOLSSON'S RADIO AND T. V.OMNI SYSTEMS INCON WITH FLOWERSONACKIE ROBERT S.ONEAL LOUOPLINGER CRAIGORTHOPAEDIC CLINICORTHOPEDIC CENTERORTIZ GERARDO RORTIZ JOSEPHORTIZ LUCASORTIZ MICHAEL DORVIN MARTYOSBORNE ASHLEA MOSBORNE BERTOSBORNE GLANUS TOSBORNE SAMUELOSBURN ROBINOSGOOD CONSTRUCTIONOSTEAN BARRY LOSTEEN THOMAS A.OTT TOMOTTER CONSERVATION CENTER FAXOTTO TONY L.OVERSTREET DOROTHYOVERSTREET DORSEYOVERSTREET RHODIS B.OVERSTREET SIDNEYOWEN D MOWEN ROBERTOWEN WILLIAM JJROWENS HENRYOWENS LARRYOWENS PAMELA D.OWENS RAY D.OWENS SAMUEL DJROXNER M. M.OZIER CLINT 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?
