2. 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.
6. Tennant/Owner's Legal Name
7. Last Name

9. I Hereby grant the following permission for the Village of Little Chute to revise my billing by removing a Co-Applicant namely:

11. Co-Applicant's Legal Name
12. Last Name
14. Utility Billing Account Number
16. Service Address
17. Apt.
19. City
20. State
21. Zip
23. Owner's Phone Number
24. Owner's Email
26. Co-Applicant Phone Number
27. Co-Applicant Email
29. Landlord's Name (if Applicable)
31. Landlord's Phone Number
32. Landlord's Email
34. Submit*

    1. I agree

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

36. First Name
37. Last Name
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field