208 S. Walnut Ave. z P.O. Box 800 z Owatonna, MN 55060 z (507) 451-2480 z Fax (507) 451-4940 z www.owatonnautilities.com
UTILITY RELEASE FORM
I/We give the Owatonna Public Utilities permission to release utility information for the address
of ______________________________________________ for the time period of
___________________________________________.
I/We understand that past usage information is only to be given one time applicable to one
year’s information.
I/We understand that this information is based on rates and usage levels for the above period
and does not necessarily reflect what future charges will be due to rate changes and/or usage
level changes.
If the usage at this address changes by changes in ownership or occupancy, the past usage of
utilities is questionable for comparison purposes for the new occupants.
This information may be given to: _______________________________________________.
Utility Account Holder: __________________________________________
Account #: ___________________________________________________
Signature: ___________________________________ Date: _______________________
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