Landlord Deposit Information Form

For landlords and property managers with multiple rental properties-temporary service only

SWU Policy 26: In those instances where a landlord may have a number of residential meters at one time, for temporary service, a landlord deposit of $200.00 can be made to cover the deposit for one or more service locations. When the request to terminate a water service is received, a final bill will be rendered and the full amount of the landlord deposit will be retained. The landlord deposit may be refunded at the request of the depositor, provided that the final bills for all water services have been paid. Landlord deposits are not applicable to commercial properties.

Is the landlord a company or an individual? *

Company
Individual

Name: *

First

Last

Company Name: *

Company Contact:

First

Last

Mailing Address: *

Address Line 1

Address Line 2

City

State

Zip Code

ID Provided: *

Driver's License Number
Tax ID Number

Tax ID #: *

DL Copy Upload: (Color copy of current government issued photo ID is required to set up service if registering with DL# instead of Tax ID): *

Acceptable file types: .bmp, .gif, .jpeg, .jpg, .doc, .docx, .odt, .pdf, .png, .tif, .tiff

Phone: *

Email: *

Once SWU receives this submission, a representative will contact you to gather additional information about your properties.

Note: Any unpaid final bills may be transferred to any active account where this landlord deposit is applied. Those accounts will be subject to disconnect due to unpaid final bills from other locations. If there are not any active accounts, the landlord deposit will be applied to unpaid final accounts and a new deposit will need to be established.

Deposit Agreement *

I have read and agree to the Deposit Agreement *

Please read these Deposit Agreement terms and conditions.

A deposit is being tendered by the applicant, who agrees: (i) to furnish at his/her expense a suitable
meter box and to use diligence to protect the same from frost and accident; (ii) to comply with all rules
and regulations adopted by the Springdale Water and Sewer Commission d/b/a Springdale Water
Utilities and the ordinances of the City of Springdale; (iii) that Springdale Water Utilities may terminate
service for failure to pay amounts due to Springdale Water Utilities, whether it is for water, sewer, or
any amount Springdale Water Utilities may be collecting for other services pursuant to contract,
including solid waste or garbage pickup; and, (iv) that this deposit may be applied to any outstanding
amounts owed by applicant to Springdale Water Utilities for water and sewer service provided to
applicant. For meters being used for construction use, the undersigned is fully aware that all
construction on premises covered by this application shall conform to all ordinances, building codes,
rules and regulations adopted by the City of Springdale or Springdale Water Utilities, governing
construction of buildings and structures within the limits of Springdale or its planning jurisdiction.
Springdale Water Utilities shall refund in full a deposit for meters used for construction upon request of
depositor or his authorized representative when the following conditions have been met: 1) compliance
with all City of Springdale regulations, and presentation to the department’s cashier evidence of the City
Building Inspector’s approval of construction; 2) presentation of depositor’s copy of this application; 3)
discontinuance of the temporary water service; and 4) payment of the account in full. Deposit shall be
retained in escrow without interest by Springdale Water Utilities. Springdale Water Utilities shall apply
deposit to any outstanding balance and will return balance of deposit herewith, when service is
discontinued and all rules and regulations have been fully complied with.

Signature: *

Date: *

Office note: If company name is listed, set deposit up under company name with the individual listed as a contact.

Service you can trust.

Landlord Deposit Information Form

Hours of Operation