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Forms & Applications

This page will allow you to link to any utility form or application necessary for you to begin the process of starting utilities, requesting changes in your utilities, etc.   If you cannot find the information you need, you are free to contact the utility office at 219-866-7884 at the hours listed on the left side of this page. 
 
UTILITY OFFICE FORMS
 
RESIDENTIAL APPLICATION & COMMERCIAL APPLICATION
These forms are filled out by our customers when establishing utility service(s). Customers are required to provide their Social Security number and a Photo ID. A risk assessment report will determine the required deposit(s) amount.
 
NEW TENANT VERIFICATION FORM
This is to be filled out by the landlord and sent in with the tenant before utilities will be issued.  Once utilities are issued, we will sign off on the form and the tenant returns to landlord.
 
CHANGE REQUEST FORM
This form is used when you want to update your account information; whether you want to discontinue service, change your name due to marriage/divorce, mailing address or phone number.
 
PROPERTY OWNER QUESTIONNAIRE
This form is to supply the City of Rensselaer with the owner, manager and property information.
 
REQUEST FOR PRIORITY SERVICE
This form is filled out by your Doctor to notify us of your need for Priority Electric Service in an outage.
 
REQUEST FOR WAIVER & REQUEST FOR COMMERCIAL TRASH PICKUP
These forms are used to request a waiver for the environmental fee and to identify the type of trash service you will need.
 
 
TO VIEW/SELECT ANY OF THE ABOVE FORMS PLEASE CLICK ON FORMS & APPLICATIONS LOCATED TO THE RIGHT OF THE PAGE UNDER MORE INFO.   A FEW OF THE FORMS ARE LISTED BELOW AS WELL.
 

Contact Us

Heather Smart, Utility Office Manager

In this Department

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