Landlord's Request for Tenant

LANDLORD’S REQUEST FOR TENANT

City of Omak,

I, ____________________________, being the owner of the property at the below mentioned property am notifying the City of intent to rent my property. I am hereby requesting that my tenant (listed below) receives a copy of the utility bill for water, sewer, and garbage services.

I understand that in the event the renter / tenant moves out of the property and leaves an unpaid balance on the utility account, as the owner of the property, I am responsible for payment of the unpaid balance. I further understand that any balance left owing on the utility bill for the city of Omak constitutes a lien against the property, and services will not be reinstated until the balance and lien are paid in full.

In the event the below named tenant vacates the property, I understand that it is my responsibility to notify the City.

Supporting Documents

landlords_request_for_tenant.docx (82 KB)

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PROPERTY INFORMATION

Street address of the property in Omak, WA.

Property Address *

Please include your full account number (Example 1234.0). This can be found on your bill or you can call City Hall. *The account number will not change from the owner to a tenant.

Account Number *

OWNER'S INFORMATION

Property Owner's Name *

Owner's Mailing Address *

Property Owner's Phone Number *

RENTER / TENANT INFORMATION

Renter's Name(s) *

Renter's Mailing Address *

Renter's Phone Number *

Move-in Date *

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PROPERTY OWNER'S SIGNATURE

By typing your name into the box below you are providing your "electronic signature" as acknowledgement as well as affirming that all information above is true and correct to the best of your knowledge.

Signature *

Date

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Landlord's Request for Tenant

Supporting Documents

Contact Information