UTILITIES - Owners Reinstatement Form

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UTILITIES - Owners Reinstatement Form

Today's Date*
 
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Mailing Address

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ZIP*
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Second portion of ZIP Code is optional.
Phone*
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Property Address

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ZIP*
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Second portion of ZIP Code is optional.
 
By submitting this form, you agree that you are the owner of the property listed above. You also authorize the City of Sulphur to transfer utilities into your name when the Occupant/Occupants vacate the premises.