If different from service address
I,
, declare under penalty of perjury under the laws of the
State of Washington that all of the information provided on this form is true and correct. I am the owner/agent of the above mentioned property and would like you to bill my tenant for water and sewer services as of the above date. I am submitting this application on behalf of the tenant(s) whose identity I have verified in compliance with the Federal Trade Commission Red Flag Rules. I understand that the City will not establish an account for my tenant until the City has received this written request. The termination date for my account will be the closing date indicated above but not prior to the last billing date. A final bill fee of $30.00 will be charged for all final bills. I do hereby acknowledge that as the property owner, I am responsible for water and sewer bills not paid by the tenant, including all fees, delinquent charges, interest and court fees. Further, as the owner of the above mentioned property, I understand the following tenant billing policy and my responsibilities.
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