CITY OF MANASSAS

APPLICATION FOR RESIDENTIAL UTILITY SERVICE

SERVICE REQUEST DATE ____________________________ TODAY’S DATE _____________________

NAME ______________________________________________ SOCIAL SECURITY #_________________

CO-APPLICANT ______________________________________ SOCIAL SECURITY #_________________

SERVICE ADDRESS _______________________________________________________________________

BILLING ADDRESS _______________________________________________________________________

TELEPHONE # ____________________________________________________________________________

IF TRANSFERRING SERVICE WITHIN THE CITY, PLEASE FILL OUT THE FOLLOWING:

CURRENT SERVICE ADDRESS _____________________________________________________________

DISCONNECTION DATE REQUESTED _______________________________________________________

EMPLOYMENT INFORMATION

NAME OF EMPLOYER _________________________________ TELEPHONE # ______________________

ADDRESS ________________________________________________________________________________

CONTACT PERSON (NOT LIVING WITH YOU)

NAME _________________________________________________ RELATIONSHIP ___________________

ADDRESS ______________________________________________ TELEPHONE # ____________________

I UNDERSTAND THAT A PENALTYWILL BE ASSESSED ON BILLS NOT PAID BY THE DUE DATE AS SHOWN ON THE BILL AND SERVICE MAY BE DISCONTINUED FOR NON-PAYMENT.  THE UNDERSIGNED WILL BE RESPONSIBLE FOR PAYMENT FOR ALL UTILITY CHARGES UNTIL NOTIFICATION IS GIVEN TO DISCONNECT SERVICE.  I ALSO DECLARE THAT THE INFORMATION PROVIDED IS TRUE, FULL AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.

NOTE:  IT IS A MISDEMEANOR FOR ANY PERSON TO WILLFULLY MAKE ANY FALSE STATEMENTS IN ORDER TO RECEIVE UTILITY SERVICE.  (CODE OF VIRGINIA SECTION 18.2-186)

__________________________________________________                           __________________________________________________

APPLICANT’S SIGNATURE CO-APPLICANT’S SIGNATURE

OFFICE USE ONLY:

NEW ACCOUNT # _____________________________________  OLD ACCOUNT # ____________________________________

____NEW ACCT                                ____DEP WVD-GOOD HIST                           ____ELECTRIC SERVICE ONLY

____TRNSFR                      ____LETTER OF CREDIT                               ____WATER SERVICE ONLY

____DEP REQRD               ____DEP TRNSFRD TO NEW ACCT            ____ELECTRIC, WATER, SEWER, REFUSE

COMMENTS:  ____________________________________________

CSR_________   ID VERIFY__________________                            ____________________________________________            

                                                                                              _____________________________________

CITY OF MANASSAS

INFORMATION FOR RESIDENTIAL UTILITY SERVICE

Welcome to the City of Manassas Utilities.  Our business hours are from 8:30 a.m. – 5:00 p.m., Monday through Friday.  Please read the following information and complete the attached application.   We will attempt to have your service connected within 24 hours, however it may take up to 48 hours for new service.  NO SAME DAY CONNECTS.

In order to establish utility service the following must be provided. 

Valid pictured identification (Drivers License, passport) 

Customers are asked to provide a sales contract, lease, or move-in slip.

The City of Manassas Utility Services include electric, water, sewer and refuse. Security deposits are required at the time of application and are payable in the form of cash, check, or money order.  Deposits are as follows:

For joint accounts, both signatures and valid identifications are required.

Electric service……………………………..$  150.00

Water service……………………………….$   50.00

Sewer service……………………………….$   50.00

Electric, Water & Sewer services…………..$  250.00

Security deposits may be waived with a satisfactory rating return on the credit check. City of Manassas Utilities does verify the accuracy of all information to prevent the possibility of fraud and identity theft.

Security deposits are placed on accounts for a period of one year.  If after one year, there are no disconnect notices, no returned checks, and no more than one late charge, the deposit is applied to the account as a credit.  Should you request to disconnect your service before one year, the deposit is then applied to your account and any remaining credit will be refunded.

            Checks returned will be subject to a $35.00 fee, and utility service may be disconnected without notice.

For new service or transfer of service, there is a non-refundable service charge.  This charge can be paid at the time of application or it may be applied to your first utility bill.  The service charge for an electric only account is $25.00; for accounts with both electric and water, the service charge is $50.00.

Should disconnection of your utility service occur due to non-payment, a deposit increase, reconnection charge and full payment of the account is required before reconnection of service can occur.

Please ask your Customer Service Representative for refuse and recycling information.

Regards,

Ana Davis

Utilities Services Manager