Common Contracts
1 similar Required Documents contracts
This Institution is an Equal Opportunity Provider and EmployerRequired Documents • March 18th, 2024
SERVICE APPLICATION AGREEMENT FOR MULTIPLE METER REQUEST Applicant Information Today’s Date: Applicant Name: Driver’s License # or Tax ID #: Applicant E-Mail Address: Applicant Phone #: Mailing Address City: Zip Code: SUBDIVISION DETAILS Subdivision: Unit #: Superintendent Phone #: Superintendent: Superintendent Email: SIGNATURE Applicant Signature: Date: This following information is requested by the Federal Government to monitor compliance with Federal Laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information but are encouraged to do so. This information will not be used in evaluating yourapplication or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on basis of visual observation and surname. ☐White not of Hispanic Origin ☐Black, not of Hispanic Origin ☐Hispanic Male ☐ ☐ American Indian or Al
