Utility Bill Rental Authorization Form

URL

This field is for validation purposes and should be left unchanged.

Must Fill Out All Required Fields

Owners/Property Managers of rental property must complete this authorization form to inform the City of the person(s) renting the property and where duplicate landlord bills are to be mailed. Owners/Property Managers will automatically receive late notifications for tenant’s account. **Please make sure to review the Utilities Website thoroughly and visit the Utility Pages & Ordinance Links found on this site, for important information regarding utility services for properties within the City of Yakima.

*The utility account created pursuant to this form shall be subject to all laws of WA State and the City of Yakima.

Property Address:(Required)

Government issued ID must be provided to start service.

Tenant Information

Tenant's First and Last Name:(Required)

First Middle Last

Spouse/Other First and Last Name:

First Middle Last

Is Tenant Mailing Address Different Than the Property Address?(Required)

Yes

Tenant's Different Mailing Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Tenant Contact Phone Number:(Required)

Additional Phone Contact:

Lease From (begin date):(Required)

Lease To (end date):

Property Owner Information

Property Owner Name (TRUST, LLP, LLC, Corporation Name if applicable):(Required)

*If the property owner is a TRUST, further documentation may be needed to show that person is the trustee.

Property Owner's Driver's License Number or (Tax ID/UBI Number):(Required)

*No social security number. If the property owner is a TRUST, LLP, LLC, or Corporation, we will need the TAX ID/UBI and not a drivers license number.

Owner's Mailing Address:(Required)

Street Address City State / Province / Region ZIP / Postal Code

Owner's Phone Number:(Required)

Additional Phone Contact:

Property Owner to receive copy of tenant’s bills:(Required)

Late notifications are not optional. Only bills can be opted out of.

Yes

When the tenant or non-property owner notifies the City of Yakima that they are leaving the property please select which option you want the City to take:

Disconnect Service

Continuous Service- Revert to Owner (RTO)- The service will revert back to the owner. If RTO selected fill out RTO section.

-If neither option is selected, the account will be closed and services will be ended.

Revert to Owner (RTO):

Only select a refuse tote size if you selected continuous service.

Refuse Tote:

32 Gallon

96 Gallon

If none selected tote located at residence will continue. If no active account and none selected, 32 gallon will be selected.

Property Manager Information

Property Manager Name or Business Name:

Name

Property Manager Address:

Street Address City State / Province / Region ZIP / Postal Code

Property Manager Phone Number:

Additional Phone Number:

Property Manager to receive copy of tenant’s bills:

Yes

Enter email to receive a copy of this form:

Date(Required)

Signature(Required)

I certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.

For More Information

Please make sure to review the Utilities Website https://www.yakimawa.gov/services/utility-services/ thoroughly and visit the Utility Pages & Ordinance Links found on this site, for important information regarding utilities services for properties within the City of Yakima.