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Oversized Load Notification Request Form

Oversized Load Proof of Notification
Panhandle Rural Electric Membership Association
251 Brayton Road, Alliance, Nebraska  69301
(Phone: (308) 762-1311, FAX: (308) 762-5750, email: paulg@prema.coop)

 

This section to be filled out by Mover and submitted to Panhandle Rural Electric Membership Association
Company Name:
Company Address:
Contact name:
Email:
Phone number:
FAX:
Driver Name:
Driver Mobile #:
DOT number:
Initial Contact Date:
Date of move(must be at least 10 days after the initial contact):
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