Account History Request Form

There are two options to submit your Account History Request Form.

1. Download and Print the Following PDF Application form, then drop it off or mail it to our office.

OR

2. Complete and Submit the Following Form Online and someone from our office will contact you to make payment arrangements.

This is a new form. please replace any previous forms you have on file with us. Requests will ONLY be processed by one of the closing attorneys and will not be accepted by Realtors There will be two options available to lawyers, owners or other representatives requesting billing information for realty closings. 1. Account history of the house will be supplied at no additional charge. Attorneys can calculate a prorated amount from the history of the house to be used at the closing. If this option is selected, the new owner of the house waives any right to contest the next bill regardless of the amount that may have occurred without the Department's knowledge. 2. An actual reading can be taken from the house and an interim estimate will be calculated from the reading taken. A fee of $50 will be charged for this service. This amount will be added to the next regularly scheduled bill and will be the responsibility of the owner of the property when the bill comes due. .Address: Current Owner's Name: Please check which option you prefer: I would like to receive an account history and understand that this may not include any use of water or damage to the meter that the water department may not be aware of and that these fees will be included in the next bill. understand that it is my responsibility to inform all parties of this agreement at the closing. I prefer to have an actual reading taken and an interim estimate calculated. I understand that a fee of $50 will be added to the next regularly scheduled bill and will be the responsibility of the owner of the property at the time when the bill comes due. I also understand that it is my responsibility to inform all parties of this agreement at the closing. Attorney's Name: Date: Phone: Fax: Email (Optional):

 

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