City of Troy, NY
c/o Water Billing Office
433 River Street
Troy, New York 12180
REQUEST FOR CHANGE OF BILLING NAME AND/OR ADDRESS
Date: _________________________
Account Number: ____________________________________________________
Property Address: ____________________________________________________
Owner’s Name and Address: _____________________________________________
_____________________________________________
Phone Number: ____________________________
Department of Public Utilities Rules and Regulations (Chapter IV, Paragraph 403):
Payment of Bills: “Nonpayment will result in a tax lien being placed against the property involved.”
The Property Owner requests that the billing office change the name and address on the water bill.
The Property Owner acknowledges that any outstanding water bills or shop work bills not paid by
December 1
st
will be added to the Property Owner’s taxes in January of next year.
I understand that I am responsible for the water/sewer bills. I acknowledge
that any outstanding balances (including all interest and penalties) not paid
by December 1
st
will become a tax lien on the first installment of the next
property tax bill.
____________________________________________________________
Property Owner
Name and address to be billed:
Name: __________________________________________________________________
Street Address: ____________________________________________________________
City, State, Zip:
____________________________________________________________
Public Utilities Billing Office
Phone (518) 279-7100
Fax (518) 268-1682
