Parental Authorization (Select All That Apply) (New Utility) *

In the event the Applicant changes his address from that stated on the application, the Applicant must come in personally to sign any release to disconnect or transfer the utility serves. Furthermore, in consideration of the utility services rendered, Applicant promises to pay any cost incurred by the City associated with collecting any amounts owed in connection with your account. If the City turns an account over to a collection agency, the City has the right to charge 33.3% of outstanding principle due on an account.

The Applicant agrees to maintain access to all meters located on the premises.

The Applicant is hereby notified that all bills become delinquent 15 days from the date of mailing of the bill. Upon delinquency, any outstanding balances are subject to a ten percent service charge

The Applicant is hereby notified that any check returned to the City due to NSF will result in a $25.00 service charge added to the Applicant's account.

The Applicant pays the City the sum of $ ______, as a security for payment of bills to be incurred by Applicant for all utility services provided. Upon disconnection of utility services, this sum will be applied to the Applicant's Final and outstanding bill. Any excess of deposits will be refunded to the Applicant and any remaining amount due the City will be billed to the Applicant.

The Applicant will purchase from the City all utility services used on the premises described below and will pay thereafter monthly at rates prescribed in the Code of Ordinances of the City of Morgan City, Louisiana.

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