Landlord Rollover Program – Consolidated Utility District of Rutherford County

Landlord Customer Number*

Landlord Customer Name*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Phone Number*

Email*

Last 4 of Social Security Number*

1. Property Address*

1. Account Number*

2. Property Address

2. Account Number

3. Property Address

3. Account Number

4. Property Address

4. Account Number

5. Property Address

5. Account Number

6. Property Address

6. Account Number

Would you like the above property addresses automatically transferred into your name when a tenant moves out?*