If you are human, leave this field blank.NoticeThis form is intended to begin the process of initiating a service change and is in no way a contract or binding agreement. If you have questions regarding this form please contact Tricia Poitevint (509) 922-5443. Request Type *How may we help?Change Mailing AddressChange Contact InformationDuplicate Statement [only mailed to Service Address]Role *I am the...OwnerProperty ManagerPOA/TrusteeAccount Number *Service Address *Address where Sewer and/or Water services are provided Owner/Property Manager InformationOwner Name *Owner or Property Manager NameOwner Phone *Owner or property manager phoneOwner Email *Owner or property manager emailOwner Billling Address *Owner or property manager billing addressCountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabweCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)American SamoaGuamNorthern Mariana IslandsPuerto RicoUS Minor Outlying IslandsUS Virgin IslandsZip codeDuplicate Copy *Do you want a duplicate copy of your statement to be sent to the service address? YesNoName *Name to be listed on the duplicate copy? Owner Acknowledgement *Unlike other utilities, water and sewer charges are associated with the property rather than the tenant who incurs the charges. The account for water and sewer services provided in the District is listed in the name of the owner of the property and the District’s billing statement will be sent to the owner at the owner’s address. The Owner is making written request that the District sends a duplicate copy of the bill to the address of the property, if different than the Owner’s address. In such event, the District will send a duplicate copy of the bill and any and all notices to the address of the property, but also will send of the original bill and any and all notices to the Owner at the Owner’s address. While the Owner of the property may make arrangements with a tenant on the property to pay the District’s bill for such property, the Owner ultimately is responsible for payment of all charges on the account, including any unpaid account balance, late fees, or reconnection fees. Tenants will only be listed on the account for water and sewer services as a courtesy for notification purposes. The District shall presume that the Owner’s address for all purposes related to this property is the physical address of the property unless the Owner notifies the District otherwise in writing providing the District with the correct mailing address, including street address, and e-mail address, and phone number. The Owner is responsible for notifying the District immediately in writing of any change in the Owner’s mailing address, street address, e-mail address, phone number.I have read the above statement and understand that the owner is responsible for service. reCAPTCHA is required.Submit