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2. Property Owners Agreement for City Utility Services
4. Account Number _________________________________________________
5. Route-Meter_________________________________________________________
7. Service Address*
9. Business*

   1. yes
   2. no
10. Do you Own the Bldg?*

    1. yes
    2. no
11. Residential/Primary/Rental*

    1. Residential
    2. Primary
    3. Rental
12. Seasonal*

    1. yes
    2. no
14. Business Name*
    If Business, please provide the name of Business. If not applicable = na
16. Property Owner Name:*
18. Mailing Address:*
    Mailing Address
19. City*
21. State*
22. Zip Code*
23. Email Address:*
25. Phone Number:*
26. Cell:*
28. Service Start Date*
29. Paperless Billing*

    1. yes
    2. no
33. Date On __________________________
34. Reading _________________________
35. WO# _______________________________
37. Date Off _________________________
38. Reading _________________________
39. WO#__________________________
41. Instructions
    As the Property Owner of the real property at the address provided above, I request municipal services for that property. I understand and agree to be bound by the City's Utility Rules and Regulations*, as amended, in consideration for the delivery of the City's utility services.
43. Authorization to send utility billing statement to TENANT: I authorize the Utility Billing Department to send utility billing statements and notifications to the TENANT of my property for water, sewer, and garbage services. It is my responsibility, or the responsibility of my authorized property manager if one has been designated, to contact the Utility Billing Department when a TENANT moves into or vacates the property in writing via email at utilities@cityofwhitefish.org.
45. Responsibility for payment of utility billing statements: I understand and agree that as the OWNER, I am the responsible party with whom the City is contracting utility services for, and I remain responsible for the payment of all utility bills, administrative fees and costs, including costs of collection, for municipal services furnished to the service property. All bills are due and payable upon receipt. A bill not paid within twenty (20) days of the billing date is considered delinquent unless mutually agreeable payment schedule is made in writing between the City and me. Unpaid utility bills will result in a lien against real property as provided by Montana Law and City Code. If utilities are disconnected due to non-payment of utility billing statements, full payment on the account is required, together with any administrative costs prior to restoration of utility services.
47. This agreement will continue in full force until I make payment in full for all outstanding amounts due the City and terminate utility services in writing.
49. Owner Signature and Date*
50. Owner Signature and Date*
52. *A copy of the City's Utility Rules and Regulations, as amended, is available on the City's website at www.cityofwhitefish.org, from the Utility Billing Department or from the City Clerk. Updated: 12/29/20
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

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