Tenant Billing Request Form

I would like to have Eastsound Water send a copy of the water service bill to a third-party. This third-party could be a renter/tenant, another family member, a bookkeeper, or a property manager. I am aware that as the Eastsound Water member and owner of the property, that I am ultimately responsible for all service fees, late fees, and penalties that might accrue on my account due to failures of the third-party. Eastsound Water does not “pro-rate” bills to support tenant changes in the middle of a billing cycle.

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Tenant Billing Authorization*
- I am the member/owner of this property and understand and accept the above terms.
I request that Eastsound Water send a copy of my water service E-bill to the following parties:
Member/Property Owner Name*
First Last
Member Service Address*
Street Address Address Line 2 City State ZIP Code
Member Email*
EWUA Location Number*
Format: 0x-xxxx
Member Billing Preferences*
- E-bill
- Paper Bill via U.S. Mail
- BOTH E-bill and Paper Bill
Please send copies of my bill to the following third-parties:
THIRD-PARTY 1
Name*
First Last
Email*
Phone*
THIRD-PARTY 2
Name
First Last
Email
Phone
Name
This field is for validation purposes and should be left unchanged.

This form is secure and confidential.

* Indicates a required field.