Capital Credit Disbursement Election Form

At WesTex we are always looking for new ways to serve our cooperative.  Through the Permian Basin Area Foundation, WesTex funds scholarships available to students graduating from schools in the WesTex service area.

Scholarship Opportunities – Permian Basin Area Foundation

Through this form WesTex is giving you options on how your capital credits are distributed when retired.  Below you may elect to donate retired capital credits to our scholarship fund, we can apply your retired capital credits to your bill or you may elect to receive a check per WesTex policy.  Distribution by check will remain the default if no form is submitted.  You may submit a new form at any time should you choose to change your election.  

You may enter additional forms if you have more than one Account or Member number. 

If you have any questions or concerns please contact the business office between 8:30AM and 5PM Monday through Friday.  432-756-3393

Thank you, WesTex Telephone Cooperative

"*" indicates required fields

As it appears on your WesTex bill.
Please enter a phone number where you can be reached if we have any questions.
Top Right side of your WesTex bill. If you are not sure of your account number, please contact us or leave it blank. We’re glad to help.
If you are unsure of your member number, please contact us or leave this section blank.
Disbursement Election*
Signature