Fillable Tenant Move In/ Move Out Form (City of Sumner)

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Tenant Move In/ Move Out Form (City of Sumner)

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The Tenant Move In/ Move Out Form (City of Sumner) form is 1 page long and contains:

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  • 2 check-boxes
  • 10 other fields

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File type: PDF

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TENANT RELEASE
Today’s Date: Utility Account #
Are you letting us know that the tenant is
□ Moving in □ Moving out of this address.
Effective date: (Please note that we do not back-date service.)
Service Address:
Tenant Name:
Tenant Billing Address:
Tenant Telephone #:
I understand that the utility bill will remain my responsibility and I agree to pay it if my tenant does not. I
understand that utility billings are a lien against the property served and that failure to pay same will result in
foreclosure of such lien as prescribed by the laws of the State of Washington.
For accuracy of billing, it is my responsibility to notify The City of Sumner of vacancy or other changes in billing
information as soon as possible. If I fail to notify the City of changes in occupancy, it will be my responsibility to
work out how the bill will be prorated with my tenant.
I understand that the utility bill will not be sent to the tenant until all accounts for this address are in good
standing, with all previous account balances paid. This additional tenant billing is an accommodation to me, but I
remain the party with whom the City is contracting for utilities. This accommodation is for my sole benefit and
does not create a contractual relationship between the tenant and the City of Sumner.
I understand that each time there is a change of tenants, I must renew this agreement. Each time I close an
account there will be a Final Bill Fee of $40.00. Fees are listed at www.sumnerwa.gov in the Municipal Code. I
further understand that if neither the tenant nor I pay any unpaid bill on this account that no similar agreement
will be allowed by the City of Sumner.
Owner Signature:
Owner Name (print or type):
Owner Mailing Address:
Owner Telephone #:
Return completed forms to the Finance Department in person or via fax. Photo ID is required.
For Office Use
ID checked: □ Yes □ No □ Fax □ In Person
Finance Department 1104 Maple Street, Sumner, WA 98390 253-863-8300 Fax 253-299-5509
utilities@sumnerwa.gov
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Tenant Move In Move Out Form (City of Sumner)

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Completed 27 July 2020

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