Application For Utility Service

Service Request (check one) *

Applicant *

First

Last

MI or Business Name

C/O or Person of Contact

Social Security Number/ Tax ID

Do you give permission for us to run a soft credit check? *

Previous Address (If transferring service to new location or canceling service)

Address Line 1

Address Line 2

City

State

Zip Code

Date to Disconnect

Service Address *

Address Line 1

Address Line 2

City

State

Zip Code

Start Date *

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Telephone Number *

Alternate Phone Number

Email *

Please Check Your Information

In consideration for receiving electric, gas, water, and/or sewer service from Dalton Utilities, at the above location, I hereby acknowledge responsibility for payment of service billings. *

I agree

Accounts are billed on a monthly basis and payment by the indicated due date is required to prevent interruption of service. I am responsible for electric, gas, water, and/or sewer service until the account is closed. *

I agree

Terms & Conditions:
These terms and conditions are provided for your benefit to communicate Dalton Utilities policies regarding billing procedures, payment terms and fees. By requesting services, you agree to all of the conditions listed in this document.

Deposit: Dalton Utilities requires a deposit on a rental/lease accounts, including commercial accounts, depending on the service location meter size/type. Deposits start at $50.00.
When service is terminated, the deposit on the account will be applied towards any outstanding balance. If there is no balance due or a credit remains, a refund check will be mailed to the forwarding address provided after the final billing has occurred.

Billing Cycle: Bills are issued on a monthly basis. The billing date is determined by your location within our service area. Due dates are not adjustable.

Payment Terms: Payments are due within 10 days of the bill date. Failure to receive a bill does not exempt penalties or disconnection for non-payment. We are not responsible for late remittances made through the mail service.

Loss of Discount: A late penalty of 5% will be added to your current bill amount if bill is not paid by 8:00 a.m. on the following day after the due date.

Disconnect Policy: The service will be reconnected after the delinquent balance and reconnection fee are paid in full.

Returned Payments: Returned payments will be charged a $25.00 or 5% (whichever is greater) fee. Unpaid returned payments will be subject to disconnection. Checks will no longer be accepted on accounts having two returned payments. Payments will be required in the form of cash, money order, or debit/credit cards.

Move Fees: A $25.00 move fee will be added to a bill when a tenant moves into or out of a property.

Project Share: Bills will automatically round up to the next dollar to be donated to project share unless customer opts out.

Terminate Service: Only an account holder listed on an account can terminate service. Verification of personal identifying information will be required. Service will be disconnected the same day or at a later specified date if requested after 2:00 pm, excluding weekends and holidays. A final reading will be taken on requested termination date and a final bill or deposit refund check will be mailed to the forwarding address provided.

Reinstated Service: Accounts with outstanding balances will be required to pay the entire past due balance before new service can be established; along with any deposits required and/or service fees.

Tampering Policy: In the event a meter or service equipment has been tampered with or unauthorized usage has occurred, service will be disconnected immediately. A Tampering Fee ranging from $75 to $150 will be due before service can be restored.

Water Leaks Policy: If a water leak is found on the customer’s side of the meter, it is the customer’s responsibility to have the leak repaired immediately. A leak adjustment may be granted after evidence and confirmation of repairs are made on residential accounts only.

Payment Options:
For more information, please visit our website:
www.dutil.com

I have read and agree to the terms and conditions. I further understand that applications will not be processed without appropriate identification, documentation and payment. *

I agree

FOR OFFICE USE ONLY

Account#

WO#

Closing Date/Beginning Lease Date

(Documentation Required)

Deposit

Service Fees

Total Amount

Location Services