Hamlet Utility Application

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Hamlet Utility Application

The applicant(s) must be the owner of the below residence to apply for water and wastewater services. If you would prefer the MD of Taber utility invoices to be forwarded to the tenant, download the Tenant Permission Form.

<form-template>
	<fields>
		<field type="date" required="true" label="Service Start Date:" class="form-control calendar" name="date-1667321059909"></field>
		<field type="text" subtype="text" label="Tax Roll Number:" class="form-control text-input" name="text-1667321097655"></field>
		<field type="header" subtype="h3" label="Property Address" class="header"></field>
		<field type="text" subtype="text" required="true" label="Physical Street Address:" class="form-control text-input" name="text-1667321141663"></field>
		<field type="select" required="true" label="Hamlet:" class="form-control select" name="select-1667321165431">
			<option value="(SELECT HAMLET)" selected="true">(SELECT HAMLET)</option>
			<option value="Hamlet of Enchant">Enchant</option>
			<option value="Hamlet of Grassy Lake">Grassy Lake</option>
			<option value="Hamlet of Hays">Hays</option>
		</field>
		<field type="header" subtype="h3" label="Mailing Address" class="header"></field>
		<field type="text" subtype="text" required="true" label="Address:" class="form-control text-input" name="text-1667323335944"></field>
		<field type="text" subtype="text" required="true" label="City / Town / Hamlet:" class="form-control text-input" name="text-1667323380930"></field>
		<field type="select" required="true" label="Province:" class="form-control select" name="select-1667323424416">
			<option value="(SELECT PROVINCE)" selected="true">(SELECT PROVINCE)</option>
			<option value="AB">Alberta</option>
			<option value="BC">BRITISH COLUMBIA</option>
			<option value="MB">Manitoba</option>
			<option value="NB">New Brunswick</option>
			<option value="NL">Newfoundland and Labrador</option>
			<option value="NS">Nova Scotia</option>
			<option value="NT">Northwest Territories</option>
			<option value="NU">Nunavut</option>
			<option value="ON">Ontario</option>
			<option value="PE">Prince Edward Island</option>
			<option value="QC">Quebec</option>
			<option value="SK">Saskatchewan</option>
			<option value="YK">Yukon </option>
		</field>
		<field type="text" subtype="text" required="true" label="Postal Code:" class="form-control text-input" name="text-1667323400826"></field>
		<field type="header" subtype="h3" label="Applicant(s)" class="header"></field>
		<field type="text" subtype="text" required="true" label="First Name:" class="form-control text-input" name="text-1667323607811"></field>
		<field type="text" subtype="text" required="true" label="Last Name:" class="form-control text-input" name="text-1667323635876"></field>
		<field type="text" subtype="text" required="true" label="Phone: Residence" placeholder="123-456-7890" class="form-control text-input" name="text-1667323663267"></field>
		<field type="text" subtype="text" required="true" label="Phone: Business" placeholder="123-456-7890" class="form-control text-input" name="text-1667323699942"></field>
		<field type="text" subtype="text" required="true" label="E-Mail:" class="form-control text-input" name="text-1667323749471"></field>
		<field type="checkbox" label="Register For E-Billing:" description="If you would like to register your email for e-Billing, please check this box." class="checkbox" name="checkbox-1667323762101"></field>
		<field type="text" subtype="text" label="Previous Owner First Name:" class="form-control text-input" name="text-1667323933371"></field>
		<field type="text" subtype="text" label="Previous Owner Last Name:" class="form-control text-input" name="text-1667323959764"></field>
		<field type="paragraph" subtype="p" label="This contract is not transferable. The undersigned agrees to give written notice before vacating the said premise(s) and not to be liable for all water and wastewater charges until such written notice is given." class="paragraph"></field>
		<field type="paragraph" subtype="p" label="Owner accounts in arrears 90 days from the billing date will have the balance due transferred to the property tax account." class="paragraph"></field>
		<field type="checkbox" required="true" label="I declare the above statements are true to the best of my knowledge, information, and belief." class="checkbox" name="checkbox-1667324102534"></field>
		<field type="paragraph" subtype="blockquote" label="Protection of Privacy - Personal information is collected in accordance with Section 33(c) of the Alberta Freedom of Information and Protection of Privacy Act (the FOIP Act) and will be protected under Part 2 of that Act. It will be used for the purposes of administering the program or service for which the information is collected. Should you require further information about the collection, use and disclosure of personal information, please contact the FOIP Coordinator by calling 403-223-3541.  " class="paragraph"></field>
	</fields>
</form-template>