Residential Utility Transfer Application

Moving Out

Move out service address:

Moving in

Move in service address:

Applicant Information

Mailing address (if different from move-in address)

Access your utility information anytime from the secure internet site by signing up at www.medicinehat.ca/eutility

Requirements

Deposit – A deposit is equivalent to two months utilities over the past 12 months of service for the applicable address.

A deposit is required if you are NOT the owner of the property, and have one of the following:

1. No credit history with the City of Medicine Hat

2. Have unacceptable credit history with the City of Medicine Hat

If you currently have a deposit, this will be transferred to your new utility account. However, you may be responsible for an additional deposit amount. Please contact Customer Service at 403-529-8111 to have your credit history reviewed.

Deposits must be paid at the time of registration.

Pre-Authorized Debit – This payment method is available to all homeowners or applicants with good credit history.

I hereby authorize the City of Medicine Hat and its Financial Institution to debit the bank account provided for the balance of the Utility account each month. I also acknowledge that the payment will be forwarded to the bank at least 3 business days prior to the actual withdrawal date. I am also aware that bills with a total credit amount will result in no transaction activity on my bank account for that month.

By submitting this application/form you acknowledge and agree that any electronic signature provided by you herein is the same as a handwritten signature for the purposes of legality, validity, enforceability, and admissibility.