HomeMy WebLinkAboutRequestForService-NewPropertyOwnerREQUEST FOR SERVICE – NEW PROPERTY OWNER
City of Oshkosh Utilities ● 215 Church Ave, Oshkosh, WI 54901
Email: utilitybill@oshkoshwi.gov Office: (920) 232-5325
INSTRUCTIONS: This form MUST be COMPLETED in its entirety and returned to the Utility Accounting Department in
order for your request to be processed.
* Include your mailing address (if different from the serviced property address).
* Include a telephone number where you can be reached during business hours.
* Service Requests are for Future Dates Only
Account Number:
(if known)
SERVICED PROPERTY INFORMATION (REQUIRED)
Address:
City/ST/Zip:
Date of Closing:
BUYER/NEW PROPERTY OWNER INFORMATION (REQUIRED)
WILL PROPERTY BE: PRIMARY RESIDENCE: RENTAL:
First M.I. Last
Name:
Phone:
Landline: Cell Phone:
Name 2:
Email:
Bill Delivery: Email Postal Mail Both
Mailing Address(if different from Property Address):
City/ST/Zip:
**PRIOR ADDRESSES IN OSHKOSH WITH WATER ACCOUNT IN YOUR NAME**
Title Company Used:
Phone:
SELLER/ FORMER OWNER FINAL BILL INFORMATION (IF KNOWN)
Name: Phone:
Landline: Cell Phone:
Address for Final Bill:
City/ST/Zip:
I understand that once utilities have been approved and put into my name, it is my responsibility to notify the utility of
any changes in occupancy at this location. I understand that I am responsible for the utility charges incurred at this
location until I provide notice that I have moved and am no longer responsible for this utility bill.
I FURTHER AUTHORIZE THE OSHKOSH UTILITIES TO BILL ME FOR SAID SERVICE AND I AGREE TO PAY FOR SAID SERVICE
AT RATES ON FILE WITH THE WISCONSIN PUBLIC SERVICE COMMISSION AND/OR CITY OF OSHKOSH.
Signature:
Date:
Office Use Only
Signature: