Landlord Application

Service Address
Service City
Service State
Service Zip
Landlord or Representative Name
Company Name
Taxpayer I.D. #
Cell Phone
Home Phone
Work Phone
Mailing Address
Mailing Address
Mailing City
Mailing State
Mailing Zip
Emergency Contact
Emergency Contact
Emergency Contact Relationship
Emergency Contact Phone

Signature
Date
Email Address
I hereby guarantee to the Waterville Gas Company the prompt and full payment of all charges for natural gas supplied by said company to the above address between tenant occupancy. Gas service will automatically be transferred to the landlord between tenants and will not be shut off when tenant request final reading

Mailing Address