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Mailing/Rental Change Form

  1. *Must be the Homeowner, if you are a Property Manager please submit contract*

  2. Address in which we are servicing Water & Garbage **City/State and Zip code not required 

  3. *If known

  4. Separate from the Service Address- If this is for a Rental this is required to be different.

  5. * Important to make sure it goes to the correct City and State, PLEASE make sure to have all three.

  6. *Confirmation will be sent with instructions please make sure this is valid and you mark utilities@bluffdale.gov as a contact/safe sender or it will go to your junk.

  7. Please list an additional e-mail so we can make sure you receive the notification in case the primary account holder does not receive. 

  8. *Must be a valid phone number

  9. Please list the Name of the Company for the Property Management, an E-mail and a Phone Number of who the point of contact is if the account becomes delinquent.

  10. Example: Changing into a Rental Property, Moving

  11. Governmental entities must obtain and process only the minimum amount of personal data reasonably necessary to efficiently achieve a specified purpose, retained for required period. Utah Code § 63A-19-401(2)(c)

  12. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  13. *Required for Property Management purposes*

  14. Leave This Blank:

  15. This field is not part of the form submission.