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Michigan Residential Owner Agreement
This form is used to indicate how you would like energy service(s) provided to your residential rental property when it is between tenants. This information will be used to determine future billing responsibility when there is no tenant.

Indicates required form fields.

Property/Owner information
Property address:

City:
State:

Zip:

Legal ownership name:
(Entity/person who is responsible for the bill between
 tenants per the agreement)
Project/division
name (if applicable):
Owner address:
City:
State:
Zip:
Owner e-mail:
Owner phone: day
evening
 
Tax ID/SS#:

Please indicate how you would like responsibility for energy service(s) handled between tenants by selecting one of the following owner agreement options. The agreement you select will apply to both the electric and gas services.

Option 1 — All year agreement
I accept billing responsibility for energy service between tenants. By selecting this option, I will be billed for all energy usage between tenants unless I notify We Energies otherwise.

Option 2 — Lock/disconnect agreement
I do not want to assume billing responsibility between tenants. I request We Energies terminate service to the rental dwelling unit. (See Disconnection Rules for additional requirements.)

Option 3— No permanent agreement
I do not want a permanent agreement. I understand that you will notify me at each tenant change and ask me to select whether I want energy service placed in my name or disconnected. (See Disconnection Rules for additional requirements.)

Please mail the bills to:
my owner address shown above or
the address listed below:

Mail bills to address:
Street address:  

City:  
State:
 
   
Zip:
 

Disconnection rules
If you choose to have service disconnected at a meter(s) located inside a building or an otherwise inaccessible location, you will need to provide access for our metering staff to disconnect the service(s). Under Michigan Public Service Commission Administrative Rule R460.2162 (d)(i) for disconnections, we are required to verify that residential premises are unoccupied before disconnecting service. After each tenant change, we will need your written statement, under oath, that the premises are unoccupied before we can disconnect service.

The agreement I selected above applies to all units in the building/complex?
Yes    No

I would like this owner agreement to apply to the
following residential rental properties as well (please list)
Address:
City:  
State:  
Zip:
 

Address:  
City:  
State:  
Zip:  

Address:  
City:  
State:  
Zip:  

This property has been sold to
Name:
Date sold:
Address:
City:
State:
Zip:
Phone:
I have never owned this property
I only manage this property

Property management company information (if applicable)
Name:
Contact name:
Phone:
Address:

(Between tenants, bills will be mailed to this address)
City:
State:
Zip:
Fax number:
Tax ID/SS#:
E-mail:   

Name of person completing the form:
Completer Email:
Completer Phone:
Form Date: