Billing Authorization Landlord Request

Water service is not transferred to a tenant of a property, nor is an account opened in a tenant’s name. The service will always remain in the property owner’s name and the owner will receive the original bill. Upon the owner’s authorization, the District will mail a bill copy to the service address as a courtesy to the tenant. The bill copy will be addressed to the tenant’s name. With this authorization, the tenant can make bill payments.

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I am a Landlord and Request to Authorize

Landlord Request*

Add Authorized Person

Remove Authorized Person

Service Location Details

Effective Date*

Company*

Company

Service Address*

Street Address Address Line 2 City State ZIP Code

Assessor's Parcel Number (APN)

Primary Account Holder

Full Name*

Primary Account Holder*

First Middle Last

Last 4 SSN*

Date of Birth*

Last 4 SSN*

Date of Birth*

How Can We Reach You?

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Email Address*

Enter Email Confirm Email

Phone Number*

Phone1 Type*

Phone1 Number*

Phone2 Type

Phone2 Number

Preferred Method of Contact*

Duplicate Billing Type

Duplicate Billing Type*

Tenant

Property Management Company

Duplicate Billing Information

Full Name*

Tenant/Property Manager Name*

First Middle Last

Property Management Company*

Company

Tenant or Property Management Phone Number*

Consent

Consent*

I do hereby acknowledge that I will remain responsible for unpaid account balances for water or sewer provided by Utility Management Services. If my tenant moves out and leaves a balance of any size, I understand that as the property owner I will be responsible for payment of said debt.

I will ensure that all balances prior to this tenant’s move-in are paid and understand that any unpaid balances can/will result in service disconnection to the above-stated address. I also understand that tenants will be directed to contact their landlord or Property Owner/Management Company should the utilities be terminated due to non-payment of services prior to their move-in date.

I understand that this utility billing account will remain in the “Property Owner” name and sent to the person named herein at my request. I will notify Utility Management Services of vacancy for a final read.

I acknowledge that I will receive monthly statements for this account. If the account becomes delinquent, I will be sent a copy of each delinquency notice that is sent to the tenant. I further agree that any and all amounts due for water and/or sewer shall constitute a lien on the real property which will secure the amounts due. Termination of service to the property will not release any lien for amounts due.

I permit UMS to release any information requested about this account to the aforementioned tenant during their tenancy. The information released may be, but is not limited to; the account balance, payment history, or delinquency status.

I understand that the move out date cannot be “back-dated”. All changes to account information will be processed up to 48 hours after being notified, if received after the move-out date. All discrepancies between the owner and tenant as regarding any portion of a bill prior to the move-out or notification date must be resolved between the owner and tenant.

I do hereby certify that I am the owner or the duly authorized agent to make this request for the owner of the subject property receiving the service. By signing below, I further acknowledge that I have read, understand, and agree to the Terms and Conditions set forth above.

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SUBMISSION DATE

Our offices will be closed until Monday December 2nd, for Thanksgiving. If you have any urgent issues, you can still call into your district for assistance.

Billing Authorization Landlord Request

I am a Landlord and Request to Authorize

Service Location Details

Primary Account Holder

How Can We Reach You?

Duplicate Billing Type

Duplicate Billing Information

Consent

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