Utility Account Form

Service Change:

Moving in

Moving out

Update Current Account Information

Only use "Update Current Account Information" when updating a mailing address, phone number or email address. All name changes to an account are considered "Moving in"

Date of Service:

Transfer of Ownership. Due to our bill cycle, dates cannot be entered for the previous month.

Please Note:

The City of Gladstone requires property owners to transfer services into a renters name. A renter can complete the form below to make sure accurate information is being provided but services will not be transferred till a property owner or manager has contacted the City by completing the below form as a "Rental Property Owner/Property Manager" or emailed the information to ub@ci.gladstone.or.us

Account Holder Status:

Owner

Renter

Rental Property Owner/Property Manager

If you are the owner of a rental property or a property management company, please select Rental Property Owner/Property Manager to complete the form for your renter.

Business License Number:

The City of Gladstone requires all Rental Property Owners and Property Managers to have a business license. Please enter your City of Gladstone business license number below. If you do not have a business, please contact bl@ci.gladstone.or.us for more information.

Name on Account:

Renters Name:

Please enter renters name

Service Address:

The address where the property is located.

Forwarding Address:

Please include City, State and Zip Code.

Mailing Address:

If different from service address

Phone Number:

Renter's Phone Number:

Email Address:

PLEASE NOTE: Email address is REQUIRED if you wish to sign up for paperless billing

Property Owner/Management Name

Property Owner/Management Phone Number

Property Owner/Management Email Address

Paperless?

Yes

No

Both

Check "YES" if you would like to only receive an emailed bill or "BOTH" to receive a paper and an email bill

New Owner

If available, please list the first and last name of the new owner.

Comments or Questions?

If you have any questions, please call 503-557-2771 or email at ub@ci.gladstone.or.us

Property Owner Signature

As the property owner, I understand that all unpaid City of Gladstone Utility charges may become a lien on my property.

Renter Signature

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