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Residential Utility Application

Steps

  1. 1. POLICY & AGREEMENT
  2. 2. SERVICE INFORMATION
  3. 3. APPLICANT INFORMATION
  4. 4. CO-APPLICANT INFORMATION
  5. 5. CONNECTION QUESTIONNAIRE
  • POLICY & AGREEMENT

    1. SOCIAL SECURITY NUMBER PRIVACY POLICY

    2. Protection of Information

      The City of Oberlin recognizes the importance of maintaining the confidentiality of the social security number and shall protect this information at all times by storing it electronically. Access to this information shall be limited to City of Oberlin customer service employees only. This information shall be destroyed approximately four years after the customer terminates all services unless kept for collection purposes. This information may be provided to credit or collection agencies.

    3. By checking the box below you confirm you have read and understand the Social Security Number Privacy Policy.*

    4. UTILITY APPLICATION AGREEMENT

    5. The Applicant(s), whose name(s) appear on this application, applies to the City of Oberlin for some or all of the following services: Electric, Water, Sewer, Garbage and other services incident thereto, to be supplied at the address herein described, and upon request, at any other local address to which Applicant may move. The Applicant agrees to pay a $25 connection fee for each electric and water connection. The Applicant agrees to pay for said services as bills are rendered therefore, in accordance with the rates, rules and regulations as provided in the City Ordinances as now existing or as may be enacted and in effect at the time of delivery, regardless of who the consumer might be. The Applicant further agrees to release and discharge said City of Oberlin from a liability for damages suffered (1) by reason of electric or water currently furnished to the premises, or (2) by reason of interruption, discontinuance or disconnection of service hereunder from any cause other than negligence by the City of Oberlin or (3) by reason of the condition, maintenance, location, or existence of any of the facilities, fixtures or systems located on or adjoining the property supplied and by which services are furnished and delivered. Service requests for disconnections will be processed within 48 hours. Applicant agrees to follow all current or as amended policies and procedures established in the Oberlin City Ordinances. Such policies and procedures can be found on the website provided here: www.oberlinkansas.gov

    6. By checking the box below, you confirm that you have read and understand the Utility Application Agreement.*