Required fields are marked with asterisks (*)

Utilities for New Renters

If you are a renter in the City of Cold Lake and your are responsible for the payment of utilities please complete this form to ensure we have the correct information when City utility bills are issued.

Per the City's Utility Bylaw, Bylaw No. #441-UT-12, the City is not responsible for incorrect information put on the form and if the information is incorrect the renter will be responsible for the appropriate interest and penalties. The property owner will receive a copy of the bill.

Section 1: Renter Information

Renter Name

Renter Email Address

Renter Mailing Address

Renter Phone Number

Move In Date

Section 2: Property Address

House Number

Street Number

City

Province

Postal Code

Section 3: Property Information

Utilities Account Number (If known)

Property Owner's Name

The City of Cold Lake charges a $2.50 fee for paper copies of utility invoices. Please indicate the method of receiving an invoice

Paper

I acknowledge that the information provided on this form is accurate and that all parties are aware of its submission. All parties consent to the information, personal or otherwise included in this form.

I agree

Information on this form is collected for the sole use of the City of Cold Lake and is protected under the authority of the Protection of Privacy Act, Sec. 4 (c), which regulates the collection, use, and disclosure of personal information.

If you have any questions or concerns, please contact the ATIA Coordinator by email (legislative@coldlake.com) or phone (780) 594-4494 ext. 7915.