2. Purchased Home
3. Sold Home
4. Rental (move in)
5. Rental (move out)
7. FINAL METER READ DATE [MM/DD/YY]*
   HOMEOWNERS (enter CLOSING date); RENTERS (enter date moving in or out).
9. Billing/Business Name(s) [*NOTE: for residential property & apartment renters, MUST be name of property owner]*
11. Property Address*
13. Forwarding (if moving out)---OR---Billing address (street):
15. Forwarding / Billing Address [line2]
17. Forwarding / Billing City, State, Zip Code
19. NEW HOME OWNERS: # of people that will be living in home?
21. Phone number (###-###-####)*
23. Email address
25. Contact Name (for Commercial property accounts)
27. Comments
29. Privacy Statement
    The Minnesota Data Privacy Act requires that we inform you of your rights about the private data we are requesting on this form. The following data contained on this form will be considered private data pursuant to M.S. 13.548: the name, address, telephone number, any other data that identifies the individual, and any data that describes the health or medical condition of the individual, family relationships, and living arrangements of an individual or which are opinions as to the makeup or behavior of an individual. We need this data to register you for a program and to contact you if necessary. City of St. Cloud staff will have access to the data you provide to administer the program. You are not legally required to provide the data; however, refusing to supply the data may cause your registration to not be processed. Your acceptance here indicates you have read and understand these rights.
31. Privacy Agreement*

    1. I have read and agree to the data privacy policy
Leave This Blank:


33. Submit

* indicates a required field