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Requests for Utilities

SIGN UP FORM FOR UTILITIES

Winner Municipal Utilities

Name: ________________________________________________

Address: ______________________________________________

Phone Numbers:

            Home: ________________  Work: ________________  Cell: _____________

CONTACT PERSON: ________________________   Phone: __________________

EMPLOYER: __________________________________________

OWNER OF HOME: ____________________________________

LIVED IN WINNER BEFORE?        YES                 NO

X ______________________________________  DATE: __________________
            (SIGNATURE OF APPLICANT) 

This form must be filled out and brought into the City Finance Office with your deposit.
NO TRANSFERS WILL BE DONE UNTIL THIS IS COMPLETED!!

DEPOSITS REQUIRED

$150.00 for residential with no previous credit reference from an Electrical Company.

$50.00 for residential with an approved credit reference.

$60.00 for Business account with reference

Any question please contact Linda at the City Office. (605) 842-2606