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Utility Billing Removing Co-Applicant

  1. REMOVING Co-Applicant 

    • Will no longer accept financial responsibility and agrees that if the applicant owes the Village of Little Chute for any past due utility bills, all unpaid bills must be PAID IN FULL prior to closing the account.
    • Will no longer have full access to 
      1. the billing account and updating information.
      2. Starting, stopping, or transferring services.
      3. Setting up payment agreements.
  2. I Hereby grant the following permission for the Village of Little Chute to revise my billing by removing a Co-Applicant namely:

  3. Submit*

    By Submitting this form I certify that the above information is mine and all statements on this form are true and correct.

  4. Leave This Blank:

  5. This field is not part of the form submission.