Get Property Utility Disclaimer Statement

Filling out the Property Utility Disclaimer Statement online can seem daunting, but with careful guidance, you can navigate it smoothly. This document authorizes the release of utility information to a designated third party and ensures seamless management of your utility services.

Follow the steps to complete your Property Utility Disclaimer Statement online.

1. Press the ‘Get Form’ button to access the Property Utility Disclaimer Statement in a digital format.
2. Begin by filling in your personal information in the Customer’s Information section. This includes your Owner’s Name, Company Name, Social Security Number or Federal Tax ID Number, Mailing Address, Phone Number, and Email Address.
3. In the Authorized Party’s Information section, specify the Third Party’s Name and their Phone Number and Email Address to whom the utility information should be sent.
4. Complete the Address Where Bills Should Be Sent section by providing the complete address where the utility bills should be directed.
5. List the Service Location(s) included in this authorization by filling in the respective fields. If there are additional locations, attach a separate sheet as needed.
6. In the Information to Be Authorized section, check the appropriate boxes to indicate what information the Third Party Agent is authorized to access, such as billing history, service connection or disconnection, and the Revert to Owner Agreement details.
7. Read the Terms and Conditions of the Revert to Owner’s Agreement thoroughly before checking the acknowledgment box to indicate your understanding and agreement.
8. Specify the duration of the authorization in the Expiration/Termination of Disclaimer section by selecting the preferred option: a specific date, two years, or three years.
9. Proceed to the Acknowledgment and Signature section. Here, you must affirm your authority to sign the document, provide your signature, print your name, state your position, and include your employer's name.
10. Once all sections are completed, you can save changes, download, print, or share the document as necessary, and ensure to email the form to AccountSupport@DomEnergy.com.

Complete your Property Utility Disclaimer Statement online today and manage your utility services with ease.