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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