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2. This form is for tenants only to request a special move-in or move-out water utility meter read.
   We will not put a bill into a tenant’s name without the approval of the landlord.
4. Tenant Contact Information
6. Requester Name*
7. Email*
   Valid email required.
9. Phone*
10. Move Type*
    -- Select One --Move InMove Out
12. Service Address
14. Type*
    -- Select One --CommercialMulti-Unit ApartmentSingle Family Home
15. House, Building or Apartment Number*
17. Street Name*
18. Direction
20. City / State / Zip*
22. Note this submission will be timestamped when it is submitted. Water readings that are back-dated will be rejected
24. Date of Reading*
    Date of Reading
25. Landlord Name*
27. Final Billing Mailing Address for Move Outs
29. Billing Name
30. Billing Address
32. City
33. State
34. Zip
36. Additional Comments
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field