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Customer Authorization Form, Water Operations
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Printable Form, Water Operations Customer Authorization Form (PDF)
Billing Name and/or Address Change
Account #:
*
Service Address
*
Street Address
Address Line 2
City
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New Hampshire
New Jersey
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North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Owner’s Name (as listed at the Town Clerk’s Office):
*
First
Middle
Last
Owner’s Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone # (important for Dept. to acquire additional info if necessary):
*
Email:
*
Are you a new owner?
*
Yes
No
Date of sale or transfer:
*
Former Owner’s (s’) Name(s):
*
First
Middle
Last
Change Billing Address To:
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
REASON: CHECK ALL THAT APPLY
*
Legal name change (court approved) and recorded on land records.
Returning to former (maiden) name and recorded on land records.
Owner’s name as listed above is incorrect. Explain:
Additional owner added to property title (circle relationship – spouse, parent, grandparent, son / daughter). Other, explain:
One or more owners deleted from property title (circle relationship – spouse, parent, grandparent(s), son / daughter). Other, explain:
Property sold, under new ownership. Relationship of new owner, if any
Moved to new address, but still own property
Company office, responsible for payment, has moved.
Change to post office box.
Changed management agent
Estate of owner. (Enclose copy of Death Certificate.)
Foreclosure.
In cases of divorce, property was sold to former spouse. Circle one – former husband / former wife.
Divorce. (In cases involving dissolution of a marriage, bills are sent to the property owner as listed on the land records.)
Owner moved back to service address.
In case of death, house was jointly owned & duly recorded on land records
In case of death, there was a survivorship clause in the deed. (Enclose copy.)
Relationship of person inheriting property other than spouse. Circle one – parent, grandparent, son / daughter. Other, explain:
Tenant is to be billed directly.
Tenant’s lease expired.
Owner residing in house.
Other
Explain
*
NOTICE TO OWNER:
The District’s tax lien status takes precedence over all liens including mortgage liens with the only exception being another tax lien. This status requires the Department to screen name changes and billing names and addresses thoroughly to protect its interests.
This status also requires the District to only bill the owner of record at the service address unless the owner’(s’) authorize(s) a different billing address.
The Department will send bills to a billing name and address, other than the owner’(s’) name and service address, at the direction of the owner. The owner is responsible to change the billing name and address as appropriate. The owner of record, under District Charter and under the Connecticut General Statutes, is legally responsible for the water bill, regardless of any personal arrangements or agreements he/she has negotiated, and regardless of to whom the owner directs the bill (using this form).
THIS FORM DOES NOT TRANSFER LEGAL RESPONSIBILITY FOR PAYMENT OF THE BILL TO ANYONE OTHER THAN THE LEGAL OWNER OF RECORD.
IF THE OWNER ELECTS A BILLING ADDRESS, ALL BILLS AND CORRESPONDENCE WILL BE SENT TO THE BILLING ADDRESS. DUPLICATE BILLS, DEMANDS FOR PAYMENT, OR CORRESPONDENCE WILL NOT BE SENT TO THE OWNER.
TYPICAL BILLING ADDRESSES INCLUDE:
A management agent’s office.
The owner’s residence, if different from the service location.
A friend, relative, or neighbor who is managing the property.
A corporation or company headquarters, or billing office.
An attorney or financial adviser.
A resident spouse of a nonresident owner.
If at any time, the billing address becomes invalid and further instructions and authorizations are not provided by the owner, the Department will change the billing address to the service address.
The owner, if not a resident of the property being served, may also provide an owner’s address for the Department’s master file. In the event of a
serious customer deficiency
not corrected by the billing addressee, the Department may attempt to rectify the problem by contacting the owner at the owner’s address. Owners who move frequently are advised that the Department should be contacted when the owner changes address to avoid outdated information in the Department’s master file.
*
This is to certify, I authorize South Norwalk Electric and Water to change the billing name and/or address on my account. I acknowledge and accept that there is a $10 fee for this service which will be placed on my account. I further acknowledge if this change reflects a property transfer between owners, my account will be charged $25. I also understand, as the owner of record, should I move back to the service address and wish to receive my bill at that location, I will not be charged
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Customer Care
Pay Your Bill
Theft of Service
Understanding Your Bill
Contact Customer Care
Finding Leaks
Rates & Fees
Streetlight Outage Report
Forms
Application for Residential Electric Service
Application for Commercial Electric Service
Application for New or Modified Electric Service
Application for New or Modified Water Service
Customer Authorization Form, Electric Operations
Customer Authorization Form, Water Operations
Request to Disconnect Service
Deposit Application
Utility Asset Information Request Form
Conservation
Rebates & Incentives
Conservation Tips
Solar
Home Energy Savings
Education
Drinking Water Report
Hydrant Flushing
Lead Rankings Report
Watershed Inspection
Where does power come from?
Where does water come from?
Water Rate Increase Report
About
Commissioners
Meet the Manager
Financial Reports
District Charter
SNEW Service Area
Rules and Regulations
I am a…
Residential Customer
Commercial Customer
Builder
Potential Vendor
Potential Employee
Home
Careers and RFPs
Calendar
Agendas & Minutes
FAQs
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