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Get Customer Registration Form Dep 2003-2024

Te NY Zip Full name, mailing address, home phone and business phone numbers of owner of property receiving service: (please provide information on owner ONLY; do NOT give information on property manager or tenant): Business: Owner s Name or Individual: (Last Name) Street Home Phone(Numbers only): (First Name) City State Business Phone(Numbers only): (MI) Zip Customer Billing Information: PLEASE NOTE: A. Water and sewer charges are the legal responsibility of the owner of a property rece.

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