Low-Volume Consumer or Designated Form for Multi-Unit Residential Premises

Low-Volume Consumer or Designated Form For Multi-Unit Residential Premises

Property Information(Required)

Account Numbers (123456-1234567)

Account Name

Basis for Qualification

Number of Units Within Property/Complex

The following individuals have the authority to provide and certify the accuracy of the information provided on this form and any additional attachments. Please fill out the applicable section.

Corporation

Corporation's Name

Corporation Name

Name & Office Of Authorized User

Sole Proprietor

Name of Applicant

Date

Partnership

Partnership's Name

Name of Authorized Individual to sign on behalf of Partnership

Date

Signature of Applicant (should be the same as the Account Name)

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Low-Volume Consumer or Designated Form for Multi-Unit Residential Premises