Account Holder Type Property Owner RenterInformation messageTown of Peace River Bylaw #1895 states “A new Account shall only be entered into for the provision of Utility Services to a parcel of land with the Owner of the parcel of land. Renters shall not be permitted to set up Accounts in their own name. Upon request of the Owner, a copy of the monthly utility bill will be provided to the Renter of the parcel.” Charges accrued are set out in agreement between the owner of the property and their tenant. The Town will not be held liable. Close Possession/Move-In Date Name First Last Birthdate Civic Address of Property House Number Street Number Mailing Address Address Address 2 City/Town Province - None -AlbertaBritish ColumbiaManitobaNewfoundland and LabradorNew BrunswickNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanNorthwest TerritoriesNunavutYukonAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAmerican SamoaArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificFederated States of MicronesiaGuamMarshall IslandsNorthern Mariana IslandsPalauPuerto RicoSaint Pierre and MiquelonVirgin Islands Postal Code Phone Number Alternate Phone Number Email Address Name of Spouse or Cohabitant First Last Preferred Method to Receive Bills Email Mail I agree to the terms of service.Terms of ServiceThe applicant is requesting utility services at the specified location and agrees to pay for these services according to the rates and conditions outlined in the Bylaws and Policies of the Town of Peace River. Past due bills will incur penalties and may result in the disconnection of services.If the applicant represents a firm, partnership, corporation, organization, government entity, or other association, the individual submitting the application must be an authorized agent for the organization.The Town of Peace River is collecting personal information for the purpose of account administration, debt collection, credit checks, customer verification and may be shared with other Town departments for a consistent purpose. The personal information on this form is collected under the authority of the Municipal Government Act Section 3 and is protected under the provisions of the Freedom of Information and Protection of Privacy (FOIP) Act. Questions about collection of this information may be directed to the Utilities Department 780-624-2574. Signature Sign above CAPTCHA
