Below is the application for Rock Rapids Municipal Utilities Service. To apply for service, complete the application, have it signed by the officers and accounting personnel, and bring the completed form into our office. Please refer to the Utilities’ general information for additional items needed.
NEW BUSINESS ACCOUNT INFORMATION
BUSINESS NAME ACCOUNT NO. _________________
ADDRESS CREDIT REFERENCE ___________
BUSINESS PHONE DEPOSIT RECEIPT NO. ___________
SECOND PHONE/FAX ELECTRIC _____________
OWN RENT WATER _____________
IF RENTING BUILDING, OWNER’S NAME GAS _____________
TOTAL DEPOSIT PAID _____________
BUSINESS OFFICE CONTACT:
BOOKKEEPER/CFO
BILLING ADDRESS
CITY STATE ZIP
PHONE BUSINESS FEIN
OWNERS & OFFICERS’ INFORMATION
OWNER/OFFICER #1
TITLE
HOME ADDRESS
CITY STATE ZIP
OWNER/OFFICER #2
TITLE
HOME ADDRESS
CITY STATE ZIP
PHONE
Please list the last utility you have received service from.
NAME ADDRESS
CITY STATE ZIP
ADDRESS WHERE
SERVICE WAS RECEIVED CITY STATE ZIP
I hereby apply for service in accordance with the Rock Rapids Municipal Utility's rules and regulations. I understand by signing this application I am jointly and severally liable for all charges incurred at this residence.
SIGNATURE ______________________________________________ DATE
TITLE
Welcome to Rock Rapids Municipal Utilities
Your Locally Owned Utility Provider of
Natural Gas, Electricity, Water & Sewer in Rock Rapids, Iowa
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