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2. PROPERTY MANAGERS AUTHORIZATION
   This form can only be completed by the Property Owner
4. Owners Name*
5. Mailing Address*
7. City*
8. State
9. Zip Code*
11. Phone*
12. Cell Phone*
14. Email Address*
18. Property Managers Name*
19. Mailing Address*
21. City*
22. State*
23. Zip Code*
25. Phone Number*
26. Cell Phone*
28. Email Address*
32. PROPERY INFORMATION
34. Account Number*
35. Address*
37. Account Number
38. Address
40. Account Number
41. Address
43. Attach additional sheets if necessary. Accounts for property addresses not listed will not be included in this authorization, all utility bills, notices and correspondence will continue to be sent to the Owner.
45. I hereby authorize the City of Whitefish to send the utility billing statements for he above-listed address(s) to the property manager listed above. He-she is authorized to act on my behalf in all matters pertaining to the utility accounts, including but not limited to the following: notifying the Utility Billing Department when a tenant moves into or vacates the property, requesting address changes, obtaining information, and making payments. I agree and acknowledge that I will not receive a copy of each utility billing statement but that I will receive a copy of delinquency notices. As the Owner, I agree and acknowledge that I am responsible for payment of the utility bills and that non-payment of the bills will result in discontinuation of service and the unpaid balance being levied as a tax against my property. I agree to notify the City of Whitefish Utility Billing Department in writing with any changes to this authorization.
47. Owners Signature*
48. Date*
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field