City of Meridian - Utility Billing Renter's Addendum

Fields marked with * are required.

I do hereby declare that I am tenant and therefore a resident at the following address and will be responsible for payment of the City of Meridian Utility Bill.
 
Address Tenant Occupying - Street *
 
 
Address Tenant Occupying - City *
 
 
Address Tenant Occupying - State *
 
 
Address Tenant Occupying - Zip Code *
 
 
Tenant Name: *
 
 
Tenant Phone # *
    
 
Tenant Email Address
 

Do you want the bills to go to a different address other than the service address?

Have you previously lived at a Meridian City address?

 

   I acknowledge that, during my tenancy, I will receive a monthly statement from the City of Meridian with a balance due each month. I agree that I will submit payment for that balance on time each month. If payment is not received each month I acknowledge that my landlord will receive a copy of the delinquent notice sent to my residence. *

 

   By electronically signing this form I permit the City of Meridian to release any information requested about this account to my landlord. The information released may be, but is not limited to; the account balance, payment history, or delinquency status. *

 

   I acknowledge that there will be a one-time Renters Fee of $20 assessed to my first bill. *

 
Driver's License or Other Govt. Issued ID# *
 
 
Issuing Agency *  (Idaho DL, Military ID, Etc)
 
 

TERMS OF ACCEPTANCE and SIGNATURE
I, the Tenant for this Renter's Addendum, warrant the truthfulness of the information provided in this application.

 
Electronic Signature * (Please type your First and Last Name)
 
 
Acceptance Checkbox  *
  I understand that by signing this document I acknowledge and agree to the above Terms of Acceptance.