I hereby authorize service to be established in my name at the above property location and agree to pay for service until discontinued at my request. I understand that this application is accepted to the availability of service at this location.
The following information is requested by the Federal Government in order to monitor compliance with Federal Laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
Meters are read each month around the 18th through the 24th. You will receive your bill on or around the first of each month. Payment is due on or before the 20th of each month. If not paid by the 20th, a 10% penalty will be added to the current amount due.