2. Landlord Information
4. First Name*
5. Last Name*
7. Phone number*
8. Email address
10. Mailing Address*

    Please list the mailing address you would like printed bills mailed.

11. City*
13. State*
14. Zip Code*
16. Additional Authorized Agent (optional)
17. Additional Authorized Agent (optional)
21. Property Information
23. Services requested at the properties listed below:*

    1. Electric and Water
    2. Electric Only

25. Please list the address(es) of the property/properties you wish to set up to revert to your responsibility between tenants. Please submit an additional form for every ten properties.

27. Property #1*
28. Property #2
30. Property #3
31. Property #4
33. Property #5
34. Property #6
36. Property #7
37. Property #8
39. Property #9
40. Property #10
44. Acknowledgements
46. Notification of Vacancy*

    The City of Eudora will not be responsible for contacting the owner, operator, or manager when notified that a tenant is moving from such location.

    1. I agree
48. Transfer of Service*

    This authorization stipulates that the charges incurred for the interim period between outgoing tenants and incoming tenants will be your responsibility. We will automatically transfer the listed addresses to your name between tenants. You will not have to contact us to have this done.

    1. I agree
50. Annual Services*

    This authorization applies to all meters provided at each address. There will be two options: electric and water or electric only. Only one of the two options can be designated to the properties listed. Furthermore, this service is continuous throughout the year, and is not available on a seasonal basis.

    1. I agree
52. Delinquent Tenant Payments*

    We reserve the right to disconnect any and all meters at an address when a tenant becomes delinquent in payment, or has in any way interfered with normal service. If this should occur, the services will be disconnected as it is still in the tenant’s name. It will not revert to your name under these circumstances. The City of Eudora will not be responsible for contacting the owner, operator, or manager when services are disconnected due to non-payment of charges by the tenant. The owner, operator, or manager must notify the City of Eudora to have services reconnected.

    1. I agree
54. Authorization to Make Changes*

    1. I agree

    All additions, changes, and/or deletions of address included in this authorization must be made by you or your authorized agent named below. You should notify us (in writing or by telephone) whenever the name of your authorized agent changes. The sale of any locations set forth below, must be reported to the City of Eudora in writing or services will continue as stated in this agreement, and will be billed accordingly.

56. Electronic Signature*

    By submitting this application, applicant(s) are signing this application electronically. Applicant(s) agree their electronic signature is the legal equivalent of their manual signature on this application. By submitting this application all applicants consent to be bound by the payment contract guidelines listed above.

    1. I agree
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58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit

* indicates a required field