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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 checking "I agree", the customer hereby contracts with the City of Medicine Hat for the utilities applied for, hereinafter referred to as the “services”. The Customer will pay to the City of Medicine Hat all amounts stated on the monthly utility billing for and in consideration of the services provided by the City of Medicine Hat, until such times as the customer applies in writing to have such services discontinued. I hereby agree to abide by all Utility Bylaws and Regulations now and hereafter in force

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.

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