Fillable 99 East Ramsey Street, PO Box 985, Banning, (City of Banning)

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99 East Ramsey Street, PO Box 985, Banning, (City of Banning)

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BROWSE CITY OF BANNING (CA) FORMS

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1
CUSTOMER INFORMATION: ACCOUNT NUMBER: _______________ - _______________
APPLICANT NAME: ____________________________________
DRIVER’S LICENSE NO.: ________________________________
SSN / ITIN / TAX ID NO.: ________________________________
DATE OF BIRTH: _____ / _____/ ________
PHONE NUMBER: (______) ______________________________
CO-APPLICANT NAME: _________________________________
DRIVER’S LICENSE NO.: ________________________________
SSN / ITIN / TAX ID NO.: ________________________________
DATE OF BIRTH: _____ / _____/ ________
PHONE NUMBER: (______) ______________________________
CUSTOMER TYPE: TENANT OWNER
CONNECT TYPE: RESIDENTIAL
CO-APPLICANT NAME: __________________________________
DRIVER’S LICENSE NO.: _________________________________
SSN / ITIN / TAX ID NO.: _________________________________
DATE OF BIRTH: _____ / _____ / _______
PHONE NUMBER: (______) _______________________________
CO-APPLICANT NAME: __________________________________
DRIVER’S LICENSE NO.: _________________________________
SSN / ITIN / TAX ID NO.: _________________________________
DATE OF BIRTH: _____ / _____ / _______
PHONE NUMBER: (______) ___________________ ___________
PROPERTY MANAGER
COMMERCIAL (A business license is required BEFORE sign-up for all
businesses, commercial properties, and multi-family dwellings can be processed.)
CLEARED FOR SERVICE CONNECTION:
ELECTRIC DATE: _____ / _
____ / _______ RELEASED BY: _____________________
WATER DATE: _____ / _____ / ________ RELEASED BY: _____________________
DEPOSITS AND SERVICE/PROCESSING FEE INFORMATION:
In order to establish service, the applicant(s) must pay a deposit for both electric and water services. The applicant may choose to have the soft credit
check ran for the possibility of having the deposits waived. Please note, all service requests must pay the required service/processing fees. The deposit
portion of this application can be satisfied three ways:
1. By paying the quoted deposit amount at time of sign-up.
2. By providing a letter of credit under at least one of the applicant’s names from another electric utility company showing one (1) year of
continuous service with no delinquencies or shutoffs.
3. By paying a non-refundable fee of $2.50 for a soft credit check, deposit is waived only if credit check results are satisfactory.
The soft credit check ratings are categorized as green, yellow, and red. Each deposit amount based on the rating is as follows:
Rating
Electric Deposit Amount:
Deposit Amount (per service):
Green $ 0.00 $0.00
Yellow $100.00 $100.00
Red $150.00
$150.00
UTILITY SERVICE REQUEST APPLICATION
99 East Ramsey Street, PO Box 985, Banning, CA 92220
Tel: (951) 922-3185 Fax: (951) 922-3165 E-mail: ubweb@banningca.gov
Business Hours: Monday through Friday 8:00 a.m. to 5:00 p.m.
Connects accepted until 3:00 p.m.
CUSTOMER ID # LOCATION ID #
NEW CITY OF BANNING CUSTOMER?: YES NO
IF NO, PLEASE LIST PREVIOUS ADDRESS:
A Valid United States Government-Issued Picture Identification for all applicants is Required to Start Service.
ADDRESS INFORMATION:
SERVICE ADDRESS: ____________________________________________________________________________________________________
MAILING ADDRESS (IF DIFFERENT THAN ABOVE): _____________________________________________________________________________
E-MAIL ADDRESS (IF APPLICABLE): ______________________________________________________________________________________
REQUESTED DATE OF CONNECT: _____ / _____ / ________
SERVICE REQUESTED: ELECTRIC WATER SEWER
*These deposit amounts are applicable to
Residential accounts only.
**Commercial accounts, please speak with
representative for more information.
$150.00
2
Deposit Amount:
Service Fees:
Other:
Electric
$
$
$
Water
$
$
$
Soft Credit Check
$
Total Due: $ ____________
TERMS AND CONDITIONS:
1. All parties who are over the age of 18 years old must be listed on the utility account. This includes individuals who are residing at the property
and/or co-signers.
2. Deposits and service activation fees are due and payable at time of service sign-up. Fees and service charges may vary depending on the
scope of the service requested.
3. All deposits collected are refundable either after twelve (12) full and consecutive payments on time or when the account is closed.
a. After the account is closed, the deposit is applied to the closing bill and the credit balance, if any, is refunded to the customer in
the form of a check.
b. Check is mailed out to the forwarding address provided by the account holder.
4. Please ensure our Field Service Representatives have access to the meter(s) at this location. If we are unable to access the meter(s) due
to locked gates, dogs in yard or any other circumstances, an additional fee of $30.00 will be billed to the account and service will not be
connected until access to the location is granted. Access must be provided for turn on of utilities from 7:30 am to 5:00 pm on the date of
request. ______ / ______
5. A late fee will be assessed to the account on the 30
th
day and a disconnection notice will be mailed. Additional charges will be required to
reconnect service once it is interrupted. ______ / ______
6. Payment must be made by the date of the disconnection notice to avoid interruption of service. ______ / ______
7. I understand it is my responsibility to pay the utility bill on time and update my contact information as needed. ______ / ______
8. Accounts could be required to pay additional deposits prior to reconnection. ______ / ______
9. I also understand all parties on the utility account are responsible for any unpaid balance (s). ______ / ______
10. I further understand that any previous accounts with the City of Banning, not collected at time of sign-up, that remain unpaid will
be transferred to my current account. ______ / ______
11. By applying for and accepting utility service from the City of Banning, the customer agrees to provide any right of way access on his/her
property to supply such service, and to access meters for maintenance and reading. ______ / ______
I/We, ________________________ / ________________________, the undersigned have completed this application for service with the City of
Banning and affirm all information is true and correct. I also agree to comply with all City of Banning ordinances, rules and policies. Furthermore, I
understand utility bills are due and payable 20 days from the billing date, regardless if a bill is received.
______ / ______
I/We understand that it is unlawful to provide false information in making this application. If it is determined that false information was given, my
services could be disconnected without further notice. By signing below, I acknowledge that I have read and understand the terms and conditions
of service with the City of Banning.
APPLICANT: _________________________ CO-APPLICANT: _________________________ DATE: ____ / ____ / ______
APPLICATION DATA REQUIRED:
Please include the following:
______ Completed, initialed, and signed utility service request application.
______ Proof of ownership / rights to property
(i.e. Grant deed, estimated/final closing statement, closing disclosure, rental/lease agreement, etc.)
______ Valid government issued identification(s).
______ Payment for application in the amount of $ __________
(i.e. Cash, Visa/Mastercard, personal check, cashier’s check or money order.)
Please note: all checks and money order must be made out to the City of Banning.
______ City of Banning business license (required for all new businesses, commercial buildings, and multi-dwelling properties.)
OFFICE USE ONLY
PROCESSED BY: ______________________________
PROCESS DATE: ____ / ____ / ______
$ 2.50
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99 East Ramsey Street, PO Box 985, Banning, (City of Banning)

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Completed 21 September 2021

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