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2. Account Number
3. Service Address*
4. Move In / Out Date*
   Move In / Out Date
6. Owner Name*
8. As owner of the above listed property, I am informing you that:*

   1. My tenant moved in.
   2. My tenant moved out.
   3. I've added a Property Manager.
   4. I've removed a Property Manager.
9. Bill to:

   1. Owner
   2. Property Manager
11. A tenant move in/out will not receive an off cycle final/new bill:
    IF a move in/out is within 3 days of the new monthly bill, the tenant is added to the account, as long as the prior balance is paid.
    
    IF a move in/out is after 3 days of the new monthly bill, the tenant is added after the bill has been paid.
    
    Owner/property management will be responsible to figure any per diem on middle of month move in/out.
13. Note: As a courtesy to the owner, only the owner may request to have the billing sent to the tenant. If the tenant vacates leaving outstanding charges, the City will not go to collections to get payment from the tenant. The unpaid charges stay with the property and therefore become the responsibility of the owner.
    
    There will be a $5 fee to add a tenant.
15. Electronic Signature*

    1. By clicking this box you are signing this form electronically
16. Owner Name*
    Please type name.
17. Date*
    Date
21. Section A: TENANT INFORMATION FOR BILLING
23. First Name
24. Last Name
25. Cell Phone
26. 2nd Phone
28. Co-First Name
29. Co-Last Name
30. Co-Cell Phone
31. Co-2nd Phone
33. Mailing Address (Service Address/PO Box)
35. City
36. State
37. Zip
39. Email Address
40. Bill Type

    1. E-Bill Only

    1. Both

    Select "Both" to receive a paper and electronic bill
44. Section B: AGENT/PROPERTY MANAGEMENT/POA
46. First Name
47. Last Name
48. Phone Number
50. Mailing Address
52. City
53. State
54. Zip
56. Email Address
57. Agent Name
61. Section C: OWNER INFORMATION FOR OWNER ACCOUNT
63. First Name*
64. Last Name*
65. Phone Number*
67. Mailing Address*
69. City*
70. State*
71. Zip*
73. Email Address
Leave This Blank:


75. 1. Receive an email copy of this form.
76. Email address

    This field is not part of the form submission.

77. Submit

* indicates a required field