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. This form is secure and confidential. Read more about our website security. * Indicates a required field. 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 AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Member Email* EWUA Location Number*Format: 0x-xxxxMember Billing Preferences*E-billPaper Bill via U.S. MailBOTH E-bill and Paper Bill Please send copies of my bill to the following third-parties: THIRD-PARTY 1Name* First Last Email* Phone* THIRD-PARTY 2Name First Last Email PhoneCommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms. This form is secure and confidential. * Indicates a required field.
