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2. Account Information
4. Name on Account *
5. Account Number*
6. Date for Account to be finalized *
   Date for Account to be finalized
8. Service Address*
   Address, City, State, Zip
9. My Account has been set - up for ACH/Automatic Bank Draft*

   1. yes
   2. no
13. Send My Final Bill To:
15. Mailing Address*
    Address, City, State, Zip
16. Phone:*
18. Acknowledgement and Signature

    I understand that I am responsible for the cost of water/wastewater service up to the date the account is finaled. The Utility will endeavor to act upon telephone, email, or verbal orders to discontinue service, but in the event of a dispute, only a written notice will be considered proof of notification. If I do not pay my account in full I understand that any final balances can be transferred to a current account and is due immediately or that my past due finaled account will be sent to a collection agency.

    By signing this application, I agree to the following:  

    I have read and agree to all Terms and Conditions outlined in the Water and Wastewater 

    Rules and Rates codified as Chapter 51 of the Rio Rancho Code of Ordinance. A copy of these Terms 

    and Conditions are available at the City Clerk’s Office or online at 

    https://www.codepublishing.com/NM/RioRancho/

     

    In the event of non-payment, I agree to pay all past due amounts, applicable late fees, and all costs and expenses of collecting such delinquent amounts, including reasonable attorney’s fees and collection agency fees of up to 20% of the total owed. 

20. Signature *
21. Date:*
    Date:

23. Revised: May 2024 | Phone: (505) 891-5020 | Fax: (505) 891-5204 | Email: UtilityCustomerService@rrnm.gov

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