Tenant Application for Municipal Utility Service

Municipal Utilities · South Bend, Indiana

Editable official PDF

Edit the agency’s original form, save your draft, attach documents, and review your completed PDF before signing or ordering delivery.

Print and mail service is available for your prepared packet. Review the destination and the agency’s acceptance requirements before ordering. Government payment is separate from document and postage charges.

OfficialPDF recovered, but source lists contact/office only and does not explicitly authorize email/mail submissions; owner authorization and deposit also required.

Official form and instructions

Your application steps6 steps · Municipal UtilitiesView steps

1Prepare your answersComplete here
Edit and save your answers on the official PDF.
Official source
2Add supporting documentsComplete here
Attach the supporting records listed by the agency. Check that every page is legible and complete.
- Owner Authorization of Service form
- Any applicable utility deposit
- Tenant signature
3Review and signPrepare here, finish outside
Complete each applicable applicant signature after reviewing the full declarations. Required notary, professional and witness signatures remain separate.
4Choose paymentPrepare here, finish outside
A deposit may apply and the office-use section includes a service initiation fee. No fixed amount appears in this application. Government fees are separate from the optional prepared PDF and postage. Review the exact amount and recipient before authorizing a check.
5Submit or order deliveryPrepare here, finish outside
Complete with the property owner’s separate Owner Authorization of Service form. Service begins only after both forms and any applicable deposit are received. Notify Municipal Utilities of move-out/termination date and contact information changes. Leave the office-use account,type-of-service,deposit,meter and liaison section blank. Identification-type and AM/PM fields say circle one in the source. Electronic overlay marks the selected option with an X below the printed text; review the generated PDF before submission.
Official submission instructions
6Keep your receiptComplete here
Save your agency confirmation and payment receipt. Track any mailing from My applications. Delivery does not mean the agency approved your application.

Official requirements and sources

Official source
OriginalPDF is titledTenantApp5.9.2025. Explicitly requires both owner and tenant forms before service starts. Office contact is not treated as delivery acceptance.

Complete your application

Required fields are marked *. Fields follow the agency’s published form. Save your work before leaving this page.

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Tenant Application for Service South Bend Municipal Utilities 125 W. Colfax Ave, South Bend IN 46601 Phone: 574-233-0311 Email: 311@southbendin.gov TO BE COMPLETED IN CONJUNCTION WITH OWNER AUTHORIZATION OF SERVICE FORM Date: Service Address: TENANT INFORMATION Name of Tenant: Primary Phone Number: If property is in the name of a business, name of legal agent of the business: Social Security Number: Federal Tax ID (if a business): Type of ID (circle one): Driver’s License State ID Passport Identiﬁcation Number: Date of birth: (MM/DD/YYYY): Date to start service: (circle one: AM PM Mailing address (if different from service address): Email address: Are you new to the City of South Bend? Yes No Do you currently have other water accounts with the City of South Bend? Yes No Continue on Back

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Review every page before signing. Professional, agency and notary signature areas stay reserved.Original blank form