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This form must be signed by the owner prior to the municipality setting up an account in the name of the tenant.
By signing this form, I grant permission for the municipality to send the utility bill for water and/or sewer charges to the tenant identified on this form, at the tenant address provided by me.
As the owner of the service address, I acknowledge that I assume full responsibility for any water and/or sewer charges, including any penalty charges, that are billed to my tenant while residing at this address and that remain unpaid beyond 30 days.
I understand and agree that failure to pay this account will result in any outstanding balance being added to my property tax account.
It is the responsibility of the property owner to notify the Municipal Office of any changes to the tenancy status of this property.
All requests for final meter readings should be received by the billing department at least one week before the requested reading date.
The undersigned consents to the obtaining of credit and/or personal information as may be required at any time in the connection with the credit hereby applied for or any renewal or extension thereof and to the disclosure of any credit information concerning the undersigned to any credit reporting agency or to any person with whom the undersigned has or proposes to have financial relations, and to the property owner.
