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City of Oakland Park
Utility & Billing Services
3650 NE 12 Ave, Oakland Park FL, 33334
Phone (954) 630-4280 Fax (954) 630-4285
E-mail ubs@oaklandparkfl.gov
Website: www.oaklandparkfl.gov
Office Hours: 8:00 AM- 5:00 PM Monday-Friday
Please print clearly and complete all sections of the form that apply to you. Submit completed application and
documentation by e-mail, fax, mail, or in person at the above address.
Please be sure to have all documents available when opening an account and a Photo ID.
The required deposit can be paid by mail or in person. A separate application is required for sanitation services.
1. Account Information
Account Holder Information Enter the appropriate information in all fields.
Account Holder Name(s): ___________________________
ork Phone Number: __________________________ Cell Phone Number: __________________________
ail Address: ___________________________________________________________________________
ave you ever had utility service with the City of Oakland Park? ___ Yes ___ No
If yes, please provide the service address: ______________________________________________________
Account Type Select one. Meter Deposit Costs
___ Property Owner (Attach a copy of your Settlement Statement)
___ Tenant (Attach a copy of your Lease Agreement)
2. Service & Billing Information
Service Address Enter the address where you wish to establish service.
Street: ____________________________________ Unit #___ City:__________________State:___ ZIP: ____________
Billing Address Enter the address to which monthly bills will be sent. If the same as the service address, leave blank.
Street: ____________________________________ Unit #___ City:__________________State:___ ZIP: ____________
Billing Method Select how you would like to receive your monthly bills.
E-mail Only ____ Paper Mailing ____ Both E-mail & Paper Mailing ____
Services Requested & Start Date Please mark which services you wish to establish and when you wish service to begin. If
rental property, please check with your landlord.
Water & Sewer ____ Irrigation ____ Service Start Date: _____________________
For Office Use Only
Customer #:_______________________
Account #:________________________
Deposit Amt:______________________
Cash __ Check __ Money Order __ CC __
Processed By:______________________
Processed Date:____________________
3650 N.E. 12th Avenue Oakland Park, Florida 33334. 954.630.4200. www.oaklandparkfl.gov
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3. Automatic Bank Draft Option
Would you like to enroll in our automatic bank draft payment option? ___ Yes ___ No
If yes, please attach a voided check to this application. You may also sign up for this service online at a later date.
If yes, please read the below statement and initial to authorize automatic bank drafts from your account.
I authorize the Financial Institution named on my voided check to pay my monthly utility bill by charging each payment to the account
specified by me. I agree that each payment shall be the same as if it were an instrument personally, signed by me. This authority is to
remain in effect until revoked by me in writing. In addition, I have the right to stop payment of a charge by notifying Utility & Billing
Services 10 business days prior to the due date on my bill. If I do stop payment, I will still be responsible for payment of my utility bill by
the due date. I understand however that both the Financial Institution and the City of Oakland Park reserves the right to terminate this
plan or my participation therein. A service fee of $15.00 or 5% of the draft amount, whichever is greater, will be charged for all returned
bank draft payments
Initial: _______
4. Acknowledgments & Agreements
Please read and initial next to each statement below.
All utility bills are due upon receipt. A 1.5% or $10.00 penalty, whichever is greater will be applied to all balances that are
not paid within 25 days the billing date. Delinquent accounts will be subjected to termination and all applicable fees and
service charges.
____ Delinquent utility accounts, in an owner’s name, will result in a lien being placed on the owner’s property. Delinquent
accounts in a tenant’s name will be reported to collection agencies and may affect your credit score.
____ Deposits shall be held in a non-interest-bearing account, all deposits (if not transferred) are applied to the final bill. If the
deposit exceeds the final bill, and no other outstanding fees or charges exist, then the remaining credit balance will be
____ The account holder is responsible for all piping beyond the City’s meter; leaks and unintended use of water past the meter
are the financial responsibility of the account holder. Adjustments are only available in limited circumstances.
____ The City’s uses smart meter technology that allows account holders to track their water consumption by the hour, day,
week, and more. This powerful tool can help customers manage their water consumption and identify potential leaks. To
begin using this service, visit: https://eyeonwater.com
____ A new account administration fee of $35.00 will be applied to your first bill.
City Updates
The City of Oakland Park sends regular e-mail communications to residents and businesses on news,
special events, and programs. Would you like to receive these updates? ___ Yes ___ No
Applicant Agreement
I agree that the information I have provided is true, complete, and accurate. I understand that I will be billed for all
utility services charged at the above address until such time that services are discontinued. I am responsible for paying
for the utility services.
Signature of Applicant: Date:
3650 N.E. 12th Avenue Oakland Park, Florida 33334. 954.630.4200. www.oaklandparkfl.gov
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