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2. This form needs to be completed in order to establish a utility billing account in a tenant's name.

   Do not complete this form if the property has a water meter that serves multiple units. Properties with water meters serving more than one unit must remain in the property owner’s name.

   This form must be signed by the property owner or, if a company, by an authorized agent of the company. If this form is signed by a property management company, the company management agreement must be provided. You can uploaded the agreement to brightonco.gov/utilitybillingdocs after submitting this form. 

   If this form is executed on behalf of a corporation, it must be signed by such officer(s) of the corporation as are authorized under the laws of the State in which the corporation is located.

4. Today's Date*
   Today's Date
6. First and last name of Individual completing form*

   MUST BE PROPERTY OWNER OR AUTHORIZED REP

8. Email for individual completing this form*
10. Are you the property owner or authorized representative? *
    -- Select One --OwnerAUTHORIZED REP (Submit property mgmt agreement after completing form)
12. Name of property management company (if applicable)
14. City of Brighton service address*
16. City
17. State
18. Zip
20. Owner's Name*
22. Owner's mailing address*
24. City*
25. State*
26. Zip*
28. Owner's phone number*
30. Owner's email
32. How would you like to receive your copy of the tenant's bill? *
    -- Select One --1) Email only (enter email above)2) Mail only (see mailing address above) 3) both Email and Mail
34. Tenant's Name*
36. Tenant's mailing address (if different than service address)
38. City
39. State
40. Zip
42. Tenant's move in date*
    Tenant's move in date

    NOTE: IF THIS DATE HAS PASSED THE TENANT ACCOUNT WILL BE ESTABLISHED AS OF THE BUSINESS DAY AFTER THIS FORM IS SUBMITTED. 

44. Tenant's phone number*
46. Tenant's e-mail
48. IMPORTANT INFORMATION
    
    

    • A tenant account cannot be set up if the property has a water meter that serves more than one unit. 
    • The property owner will receive a copy of all the tenant's City of Brighton utility bills. 
    • The property owner is responsible for notifying the City of Brighton of a tenant move out. If the City becomes aware that a tenant has moved out, the City may transfer the service back into the property owner's name.
    • The property owner is responsible for any outstanding utility bills left unpaid by the tenant. Unpaid utility bills may result in a lien on the property and/or water service disconnection. 
    • The City of Brighton may, at times, offer the tenant a payment arrangement in accordance with the City's policies. 

    
    

    By typing my name below, I am agreeing to the above information, and I attest that I am the property owner or authorized representative. If this form is being signed on behalf of a company management company, the property management agreement will be uploaded to brightonco.gov/utilitybillingdocs.
50. SIGNATURE*

    BY TYPING YOUR NAME IN THE BOX YOU ARE AGREEING TO THE ABOVE INFORMATION

Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field