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Rental Units - Utility Account Change Form

2. Utility Account Change Form - Rental Unit
   Please complete and submit this form if you are a tenant moving into a rental property or a landlord requesting utilities to be put in a tenants name(s). If you have any questions please contact the Utility Billing Department at 715-682-7056 M-F 8:00am-4:00pm.

   Please complete and submit this form if you are a tenant moving into a rental property or a landlord requesting utilities to be put in a tenants name(s). If you have any questions please contact the Utility Billing Department at 715-682-7056 M-F 8:00am-4:00pm.
4. When you submit this form we will put in a request for a special final meter reading on the date you will need to start services in your name at this location.

   When you submit this form we will put in a request for a special final meter reading on the date you will need to start services in your name at this location.
6. We must have at least a 24 hour notice to complete these requests and they cannot be completed on weekends and holidays. If you do not provide accurate information on this form it may cause a delay in your request.

   We must have at least a 24 hour notice to complete these requests and they cannot be completed on weekends and holidays. If you do not provide accurate information on this form it may cause a delay in your request.
8. Service Address:*
10. Service Start Date:*
    Service Start Date:
11. I Am:*
    -- Select One --TenantLandlord
13. Landlord/Property Owner Information
    As the landlord/property owner for this address I accept the responsibility for informing the City of Ashland with any changes in occupancy. I acknowledge that I am responsible for working with the City of Ashland if utility access is needed to this property.

    As the landlord/property owner for this address I accept the responsibility for informing the City of Ashland with any changes in occupancy. I acknowledge that I am responsible for working with the City of Ashland if utility access is needed to this property.
15. First Name*
16. Last Name*
18. DBA:
20. Billing Address*
22. City*
23. State*
24. Zip Code*
26. Phone Number:*
27. Email Address:
29. Tenant Information
    As the tenant for this service address I accept the responsibility for payment of all City of Ashland utility charges associated with this rental unit during my occupancy. I understand that should I become past due, it could ultimately lead to a lien against my personal assets wherein my name could appear on the Wisconsin Consolidated Court Automated Program (CCAP) as public record.

    As the tenant for this service address I accept the responsibility for payment of all City of Ashland utility charges associated with this rental unit during my occupancy. I understand that should I become past due, it could ultimately lead to a lien against my personal assets wherein my name could appear on the Wisconsin Consolidated Court Automated Program (CCAP) as public record.
31. First Name*
32. Last Name*
34. Phone Number*
35. How Many Occupants at this Address?
37. Billing Address (If Different from Service Address)
39. City
40. State
41. Zip Code
43. Email Address:
44. Have you ever had a utility account with the City of Ashland?*

    1. Yes

    1. No
46. Change Form Submitted By:*
47. Date
    Date
Leave This Blank:


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

    This field is not part of the form submission.

51. Submit Submit and Print

* indicates a required field