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

Fill Online, Printable, Fillable, Blank 99 East Ramsey Street, PO Box 985, Banning, (City of Banning) Form

Use Fill to complete blank online CITY OF BANNING (CA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

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

On average this form takes 9 minutes to complete

The 99 East Ramsey Street, PO Box 985, Banning, (City of Banning) form is 1 page long and contains:

  • 0 signatures
  • 4 check-boxes
  • 33 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Banning

BROWSE CITY OF BANNING (CA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
One-time Leak Adjustment Application
Unintentional water loss can sometimes be caused by broken or damaged plumbing fixtures, irrigation
equipment or pipes. If this happens at your property, you may be eligible for a one-time courtesy leak adjustment on
your bill. If an adjustment is approved, all wasted water above normal consumption will be billed at the lowest
rate possible. Please fill out the application below and submit it along with the required paperwork to the City of
Banning Utility Billing Department, which is located at 99 East Ramsey Street, Banning, CA 92220.
APPLICATION MUST BE SUBMITTED WITHIN THIRTY (30) DAYS OF LEAK BEING FOUND/REPAIRED.
You may also e-mail the request and paperwork to ubweb@banningca.gov. Please note, application must be
signed by requester and all required paperwork must be included in order to be considered for processing.
Applicant and Leak Information:
- Ac
count Number:Customer Name: ______________________________ ______ ____ __________
Phone Number: ( ) Service Address: ______________________________ _________________
Mailing Address: ______________________________
(If different from above) _______________________________
I am the: Property Owner Tenant
Property Manager Other (Please specify): ______________
Date Leak was Repaired:Approximate Date Leak Began: ____ / ____ / _____ ____ / ____ / _____
*Please attach proof of leak repair. (i.e. copy
of i
nvoice, receipts for parts, photos, etc.)
Des
cription of Leak and Repair
(Please use a separate sheet if needed): _____________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Application Agreement:
Before the City of Banning Utility Department can provide the one-time leak adjustment, normal/lower
water consumption must be verified. Therefore, the adjustment will be given only after the next reading
cycle shows that water consumption has gone back to its normal usage. Please be advised that credit will
only be given to the charges which fall under the time period listed above. _____
The leak adjustment is a one-time credit on the City of Banning Utility Bill. I understand that this property
will not be eligible for any additional leak adjustments in the future if this request is approved. _____
Date: ____ / ____ / ______
Date: ____ / ____ / ______
Date:
Customer Signature: ______________________________
Received By: ____________________________________
Manager Approval: _______________________________
____ / ____ / ______
City of Banning
99 East Ramsey Street, PO Box 985, Banning, CA 92220
Tel: (951) 922-3185 Fax: (951) 922-3165 Email:ubweb@banningca.gov
www.banningca.gov
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

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

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 21 September 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document