2025 Canby Telephone Association dba DirectLink Patronage Distribution

Patronage Distribution Form

Please complete the form to confirm your current mailing address and contact information.

Dividend payments are planned for distribution by the end of 2025 but will not be issued until the form, including Social Security Number or Business Tax ID Number for the associated account, has been submitted.

If additional information is needed, we will contact you before issuing payment.

If you have any questions, please view our Patronage Information or call 503.263.5999.

We appreciate your membership.

DirectLink Board of Directors

*** Unclaimed distributions will be forfeited back to the cooperative per ORS 62.425 ***

* indicates required

Member Number (from letter) *

First Name *

Last Name *

Please check the box below if member is deceased

Please send a Patronage estate packet to the address provided below.

Address *

Address Line 2

City *

State/Province/Region *

Postal / Zip Code *

Country

Current Phone Number *

Email Address *

Last Four of Social or Tax ID *

Agree Patronage Information is Correct *

I agree

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