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VERNAL CITY UTILITY SERVICE APPLICATION

  1. CITY, STATE AND ZIP CODE

    VERNAL, UTAH 84078

  2. EMPLOYMENT STATUS*

  3. A DEPOSIT IN THE AMOUNT OF $150.00 IS REQUIRED.

  4. UTILITY AGREEMENT*

    I, the undersigned owner of the above property, understand that utility billings are due thirty (30) days after billing. Should I become delinquent in payment of any such billing, Vernal City shall have the right to demand payment of said billing in full, plus interest at 1.5% per month, which is 18% APR, or suspend my utility service, which would require a Twenty Dollar ($20.00) reconnect fee for service to be reinstated. In the event that the utility billing account is turned over for collection I agree to pay all interest at 1.5% per month, which is 18% APR, plus all collections fees, court costs and attorney fees necessary for the collection of said delinquent account.

  5. OWNER RENTAL OPTIONS*

    OWNER RENTAL OPTIONS if the above property, owned by me, becomes a lease or rental property, I understand the following will apply: 1.) I will be responsible for utility service and request that all utility bills be sent to me. 2.) I will be responsible for utility service and request that all utility bills be sent to the tenant at the service address and understand a utility deposit in the amount of $150.00 will be paid by the tenant. I further understand and agree in the event an unpaid utility balance left owing by the tenant, I , as the property owner, will be responsible for said unpaid balance, plus interest at the rate of 1.5% per month, which is 18% APR, plus all collection fees, court costs and attorney fees necessary for the collections of said delinquent account.

  6. UTILITY AGREEMENT *

    I, the undersigned tenant of the above property, understand that utility billings are due thirty (30) days after billing. Should I become delinquent in payment of any such billing, Vernal City shall have the right to demand payment of said billing in full, plus interest at 1.5% per month, which is 18% APR, or suspend my utility service, which would require a Twenty Dollar ($20.00) reconnect fee for service to be reinstated. In the event that the utility billing account is turned over for collection, all interest at 1.5% per month, which is 18% APR, plus all collections fees, court costs and attorney fees necessary for the collection of said delinquent account. Further release is hereby given to Vernal City to obtain any and all such information from employer or references as may be deemed necessary to process this application for service or effect collection of any unpaid balance due. I, the undersigned, hereby certify that the information given above is true and correct.

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