TOWN OF NACHES



TOWN OF NACHES

29 E SECOND ST PO BOX 95 NACHES, WASHINGTON 98937-0095

UTILITY ACCOUNT CHANGE FORM

Physical Address:____________________________________Account Number_______

PLEASE COMPLETE:

WATER:  ON  OFF GARBAGE:  ON  OFF OVER 65:  YES  NO

SEWER:  ON  OFF IRRIGATION:  ON  OFF NOT PD:  YES  NO

For a change in property owner or mailing address, please complete the following:

Property owner change  Change in Mailing Address 

PREVIOUS INFORMATION: NEW INFORMATION:

Name______________________________ Owner’s Name_________________________

Mailing Address:_____________________ Renter’s Name_________________________

City, State & Zip_____________________ Mailing Address________________________

Home Phone ( )____________________ City, State & Zip________________________

Work Phone ( )_____________________ Renter’s Phone Number__________________

RESPONSIBILITY FOR UTILITY CHARGES:

All accounts for utilities shall be kept in the name of the legal property owner as listed by the Yakima County Assessor’s Office. The property owner shall be responsible for payment of all charges set for by the Naches Municipal Code and/or ordinances of the Town of Naches. At the request of the property owner, the Clerk/Treasurer may bill the consumer(s) but the charge(s) to the property shall ultimately be the responsibility of the property owner.

Signature:____________________________________Owner  Agent  Date:________

Office use only

Meter Serial Number__________Meter Reading__________Date__________By________

Date Received_____________By___File Changed__________By___Billing______By___

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