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2. Water Service Information
4. Service Start Date:*
   Service Start Date:
5. Foreclosed/HUD/Short Sale*

   1. Yes
   2. No

   If Yes, please fill out a Home Connect Form
6. Ownership:*

   1. Own
   2. * Rent
   3. * Property Manager

   * Signed Rental/Lease/Property Management Agreement is Required.
7. Water is:*

   1. On
   2. * Off
   3. * Unknown

   * Must Submit a Release or Home Connect Form
9. Release Form
   Release Form

   This form allows you to turn on water at a property without being present
10. Home Connect Form
    Home Connect Form

    This form allows you to schedule a time to have the water restored.
12. Service Address*
    Address, City, State, Zip
13. Mailing Address
    If different from Service Address
15. Do you presently have/had water/wastewater services with the City of Rio Rancho? If so, what address?
    Address, City, State, Zip
16. Is this address to be terminated?

    1. Yes
    2. No
17. If yes, what date?
    If yes, what date?
23. Applicant Information
25. Business Name:*
26. Phone with area code:*
27. Fax with area code:
29. Primary Contact Name(s):*
33. Emergency Contact:
35. Name:
36. Phone:
40. Ordinances:
42. Section 51.04A - Connection Charge: All new accounts will be assessed an administrative fee of forty-five ($45.00) dollars.
44. Section 51.05D and Section 51.12D - All customers shall be given at least twenty-four calendar days from the date of rendition of a bill for payment in full before the bill is deemed delinquent. A late fee will be assessed that is a percent of the amount owed. A delinquency charge per month, which accrues daily, will be assessed on any amount, which remains unpaid after the due date. Each calendar year, a customer will be allowed one late payment without penalty. Deposits for commercial, multi-family residential, industrial and reclaimed water customers shall be equal to three months’ utility charges for a like and similar customer.
46. Section 51.05H - Returned Check Charge: “The utility shall assess a returned check charge in the event of the customer’s check or bank draft is returned.” Fee is twenty-five ($25.00) dollars
48. Section 51.06B - Security Deposits, Guarantees of payment: Deposits for commercial, multi-family residential, industrial and reclaimed customers shall be equal to three months’ utility charges for a like and similar customer.
50. Section 51.09K - Reconnection Charge: Any customer whose service is involuntarily disconnected will be required to pay a reconnection fee in addition to all other fees and charges before being reconnected to the utility. Fee is forty - five ($45.00) dollars.
54. Acknowledgement and Signature
    I understand that a deposit will be required if a letter of reference is not provided within 30 days of the service start date. I am able to call the office at (505) 891-5020 from 8:00 AM to 5:00 PM Monday through Friday to request deposit information from any Utility Service Specialist.
56. Applicant Signature:*
57. Date:*
    Date:
Leave This Blank:


59. Submit Submit and Print

* indicates a required field