Utility Application | Town of Haxtun

Application for Service

Either complete the online application below or download, print, and submit the paper application.

Customer hereby requests that the Town of Haxtun shall provide services to customer at the location described.
Customer recognizes that metering equipment to be located on customer’s premises belongs to the Town of Haxtun, and customer shall protect said property from loss and damage, further, customer shall maintain a clear and safe access to said metering equipment for use at reasonable times.
Customer waives claim for, and will indemnify and hold harmless the Town of Haxtun from any loss or damage arising from interruption of services.
The Customer and/or the Town of Haxtun may designate a third party to be notified prior to the discontinuance of service based on non-payment by customer.
Customer shall pay a meter deposit of $200.00 for each meter. All deposits shall remain with the property and be kept on each meter for the duration of ownership. The meter deposit shall only be refunded or applied to final bill if the property is sold/ deeded to another customer.
Customer agrees to, follow rules, regulations and policies will pay for service based on rates established by the Town of Haxtun.
Vacant or empty properties will be charged monthly until service is disconnected.
The customer recognizes that the Town of Haxtun provides for and imposes charges for removal of garbage and trash from residential properties served by electricity, even though the property may be vacant or empty. It is the customer’s responsibility to provide and maintain adequate receptacles for garbage and trash.
Customer shall notify the Town of Haxtun if service is for rental property, additional information will be required for rental property.
Neither this application, nor the service supplied, shall be assignable or transferable.
The customer understands that; the utility bills are due upon receipt. A penalty of 10% of the total electric charge will be applied to all delinquent accounts on the 11th of the month. Utility accounts not paid in full by the 20th of each month will have a $30.00 disconnect fee added to the balance. A charge of $30.00 will be added to all returned checks. Checks will be accepted for the amount only. Non-Payment of accounts will be subject to disconnect with out further notice, and a reconnect fee will be assessed.

Service Information

Date of Service

First

Last

Business Name (if applicable)

Service Address

Address 2

City/Town

ZIP/Postal Code

Applicant Information

Mailing Address

Address 2

City/Town

ZIP/Postal Code

Telephone

Email Address

If rental, name of Landlord

Landlord Phone

Account Information

Security Password

Hint

What city were you born?

Who was your favorite teacher?

Who may have access to my account?

I understand that a password is required to access my personal/business account. I understand that if my password has been lost, forgotten, or compromised, I may provide the correct secret answers. In the event that I cannot supply the correct password or secret answers, I understand that I will be required to establish a new password in person, with proper government issued identification and will not be able to access additional information without full completion of this process. All information listed on this application is true and correct to the best of my knowledge; I understand fully that any false and misleading statements may be cause for the Town of Haxtun to take appropriate action. I understand and agree with the policies listed above.