Owner Acknowledgement Form

This form must be completed and signed by the owner(s). Tenants cannot sign in for service until this form is received by the District.

I/we
Owner/Property Manager*

Owner/ Property Manager
of
City/State*

City/State
will be responsible for any financial obligation for
unpaid closing bills, disconnection fees, and/or charges for damage to facilities incurred by
Tenant(s) as named on lease*

Tenant(s) as named on lease
living at
Service Address*
Street Address Address Line 2 City State ZIP Code
Lease/Rental Start Date*
MM slash DD slash YYYY

Providing this information will not terminate service under the Owner’s name. Owners will still need to call in or submit an online terminate service request. Additionally, it is the Owner’s responsibility for ensuring their Tenant(s) contact Otay Water District to establish service.
OWNER INFORMATION
Owner's Name*
First Last
Owner's Mailing Address*
Service Address and Owner's Mailing Address cannot be the same.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Owner's Primary Phone Number*
Alternate Phone Number
Owner's Email*
Acknowledgement and Agreement*
I hereby acknowledge the information submitted is true. I also understand by clicking the checkbox I agree to the terms as stated above.
Date*
MM slash DD slash YYYY

Date
Should you have questions, please contact Customer Service at (619) 670-2222 or by email at servicerequests@otaywater.gov. Business hours are Monday through Friday, 8:00 a.m. to 5 p.m.

***NOTE: COMPLETION AND SUBMISSION OF THIS FORM WILL NOT ACTIVATE THE TENANT’S ACCOUNT. THE TENANT WILL NEED TO CONTACT OTAY WATER DISTRICT DIRECTLY TO ESTABLISH SERVICE***

Requirement for Owner Acknowledgement Form is in compliance with Otay Water District’s Code of Ordinances Section 72. Failure to pay outstanding balance could result in a lien on the property and the inability to have future tenants sign in for service.