Kaukauna Utilities > Services > Application for Service > Online Application for Service

Online Application for Service

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All required fields are marked with *

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This form is for billing purposes and not to be used for New Construction Meter Installation or Upgrade of Service. Please use form noted for "New Construction".

*Application For:

Buying

Renting

Tenants Only:

If you are a Landlord, please ask your tenant to initiate this application for service.

*Account Type:

Residential Account

Commercial account

*Service Start Date:

MM/DD/YYYY

Service Address Where Utilities Are Provided

*House #:

*Street Name:

Apartment #:

*City:

*State:

*ZIP Code:

Customer Mailing Address

Different Mailing Address?:

Check if your mailing address is different from service address above.

*House #:

*Street Name:

Apartment #:

*City:

*State:

*ZIP Code:

Primary Customer Information

This person is responsible for billing.

*Company Name:

*First Name:

Middle Initial:

*Last Name:

Previous Last Name:

Maiden Name or Previous Last Name

*Drivers Lic #:

*Date of Birth:

MM/DD/YYYY

*Mother's Maiden Name:

*Social Security #:

Drivers Lic #:

Date of Birth:

MM/DD/YYYY

Mother's Maiden Name:

Social Security #:

*Phone Number:

At least one phone number is required.

Cell Phone #:

Home Phone #:

*Email Address:

*Federal ID #:

Secondary Customer Information

This person is responsible for billing. Your name must be primary or secondary to make inquiries or changes to your account.

Include Secondary?:

Check if you would like to include a secondary person on your account.

*First Name:

Middle Initial:

*Last Name:

Previous Last Name:

Maiden Name or Previous Last Name

*Drivers Lic #:

*Date of Birth:

MM/DD/YYYY

*Mother's Maiden Name:

*Social Security #:

*Phone Number:

At least one phone number is required.

Cell Phone #:

Home Phone #:

Email Address:

Preauthorize Bill Payment (Optional)

Your Kaukauna Utilities (KU) bill can be automatically deducted from your checking or savings account each month with no additional cost to you.

To enroll, fill out this form and provide us with your bank account and routing number.

NOW AVAILABLE! Customers can now sign up for automatic payments using a credit card! Sign up needs to be done while logged into your online account.

Enroll?:

Yes, I would like to enroll in bill payment from my banking institution.

*Account Type:

Checking Account

Savings Account

*Account #:

*Confirm Account #:

*Routing #:

If at any time I decide to discontinue this payment service, I will notify KU a minimum of five business days before my next due date. Your billing statement will be mailed or emailed at least 20 days prior to the due date, informing you of the amount you owe.

Payment will be automatically deducted on your due date.

The first and last name for the primary contact above is required before signing.

*Primary's Acceptance:

I authorize KU to initiate entries to the bank account listed above.

Primary's Signature:

Other Utility Account Information

*Past Customer of Kaukauna Utilities?:

Never

Past Customer

Current Customer

Past Service Address:

Please list your most recent service address.

House #:

Street Name:

Apartment #:

City:

State:

ZIP Code:

*Need a Final Reading?:

As a current customer, do you need a final reading?

Yes

No

*Date of Final Reading:

MM/DD/YYYY — Please note, we need two business days advance notice.

Digital Acknowledgment & Signature

The first and last name for the primary contact above is required before signing.

*Primary's Acceptance:

I certify the above information is accurate to the best of my knowledge and by checking this box I am digitally signing this application.

Primary's Signature:

The first and last name for the secondary contact above is required before signing.

*Secondary's Acceptance:

I certify the above information is accurate to the best of my knowledge and by checking this box I am digitally signing this application.

Signature:

Waiver Portion

Consent To Disclose Account Information

Landlord Consent:

Yes, I give consent to my Landlord

In addition to the landlord above (if checked), or instead of, you may also name another person.

I Give Consent To:

Enter full name of person wish to disclose account information.

The first and last name for the primary contact above is required before signing.

Consent:

By checking this box, I am digitally signing to give consent: I give my consent, allowing the individual(s) listed above to inquire about my utility account. I am aware information pertaining to my identity will NOT be disclosed to anyone.

Signature:

The Federal Trade Commission (FTC) requires Municipal Utilities to have in place an “Identity Theft Prevention Program.” In accordance with the FTC requirements, as well as for your protection, KU requires customers to submit an application for service with a valid form of identification. If we are unable to verify the information provided, you may be required to present valid identification in person at our office located at 777 Island St. Failure to provide proper proof of identification may be construed as a red flag as set by the FTC and may be reported to the proper authorities.

Kaukauna Utilities (KU) reserves the right to require a signed application for utility service. Application for service shall be made in the legal name of the party obligated to pay for service. Customer will be subject to current rates, rules and regulations as approved by the Public Service Commission of Wisconsin. Customer must notify KU when vacating the property to avoid being billed for charges incurred after moving.

All information provided will be confidential. False information may be cause for disconnection per the Public Service Commission of Wisconsin service rules PSC 113.0301. Residential service may be disconnected or refused for: (i) Failure of an applicant for utility service to provide adequate verification of identity and residency, as provided in sub (3).

Landlord/Tenant Agreement

A new Landlord/Tenant Agreement is required at each tenant changeover. Please provide 2 business days advance notice for the final reading to avoid billing discrepancies.

Pursuant to Wis. Stat. §66.0809 (5)(a), a property owner (hereinafter referred to as “landlord”) may elect to notify the utility in writing that a tenant is responsible for payment of the residential utility bill in order to provide the landlord with notice should the tenant become delinquent. This form will fulfill the written notice requirements set forth by Kaukauna Utilities. Upon receipt of this form, Kaukauna Utilities will follow the processes outlined in §66.0809 regarding delinquent notices, annual tax transfer notice of arrears and related lien procedures.

Notice and Lien Process

Delinquent Notices: Water and sewer balances could become a lien against the property. If a tenant fails to pay the monthly billing, the landlord and the tenant will be mailed a notice of the past due water and sewer balance 14 days after the monthly due date. If electric charges become delinquent, a separate notice shall be mailed to the landlord and the tenant notifying of possible electric service disconnection to the property.

Tenant Vacates Premises: If the tenant vacates the premises, in order for the Utility to continue sending notices to the tenant regarding a past due balance, the landlord must provide the Utility with the forwarding mailing address no later than 21 days after the date on which the tenant vacates the rental unit.

Pre-Tax Notice (October 15): Both the landlord and tenant will be mailed a notice of past due water and sewer balances on October 15 of each year for any debt incurred prior to October 1st. Once this notice has been sent, a statutory lien is created against tenant’s personal assets, which will only be enforced if the past due balance is not paid by November 15.

Tax Penalty (November 1): The Utility accepts payments through October 31 for any past due water and sewer balance listed on the Pre-Tax Notice. If payment has not been made to the Utility by October 31, the past due amounts are forwarded to the corresponding Municipality. An additional penalty of 10% will be added to the past due water and sewer amount on November 1.

Tax Transfer (November 15): If full payment is not received by the Municipality between November 1 and November 15, the water and sewer amounts listed in the Pre-Tax Notice, plus penalties, will be levied as a tax against the landlord’s property. This action will be taken in accordance with Wis. Stat. §66.0809 (3). There is no exception from the tax levy for rental property, although additional provisions may apply to certain rental properties as described below.

If the property provided with utility service is residential rental property, and the Utility has a Landlord/Tenant Agreement wherein it is stated that the tenant is responsible for payment of utility charges at the rental dwelling unit, Wisconsin law grants the Utility a lien upon the responsible tenant’s personal assets in the amount of the past due amount plus penalties. The lien becomes effective if a Pre-Tax Notice is mailed to the tenant on October 15.
If the tenant responsible for the past due utility charges pays the full amount plus penalties owed by November 15, this lien is automatically extinguished. If the tenant fails to pay the full amount owed by November 15, a notice may be filed at the County Clerk of Courts listing all delinquent tenant accounts with liens.
If the landlord pays the past due utility charges plus penalties owed by the tenant, whether before or after November 15, the lien on the tenant’s personal assets automatically transfers to the landlord as per Wisconsin law. The landlord may then file notice of the lien with the County Clerk of Courts, and notice of the lien will appear under the tenant’s name in the Wisconsin Consolidated Court Automated Program (CCAP). The landlord may, thereafter, take action to enforce the lien against the tenant’s personal assets.

This information is provided in accordance with Wis. Stat. §66.0809 (3m)(a) and (b).

Landlord Information

*Owner's Name:

The Owner's or Landlord's full name.

*Phone #:

*Email Address:

*Address:

*City:

*State:

*ZIP Code:

Tenant Agreement

As the tenant for this service address, I accept responsibility for payment of all Kaukauna Utilities charges associated with this rental unit during my occupancy and shall notify the Utility when I am moving out. By signing this agreement, I certify that I have read and understand the Notice and Lien Process of this form, and I agree to any terms and conditions outlined within. I further understand, should I become past due, it could ultimately lead to a lien against my personal assets wherein my name could appear on the Wisconsin Consolidated Court Automated Program (CCAP) as a public record.

The first and last name for the primary contact above is required before signing.

*Primary Tenant:

By checking this box I am digitally signing the tenant agreement above.

Primary Signature:

The first and last name for the secondary contact above is required before signing.

*Secondary Tenant:

By checking this box I am digitally signing the tenant agreement above.

Secondary Signature:

Additional Comments:

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