Residential Form

Residential Utility Application

Please be aware that a $25 setup fee will be added to your first bill.

Please note that if you want a second individual to have access to account information they must be listed as a joint applicant on this form.
Set Up Fee & Deposit
All CUSTOMERS both tenants and home owners shall be required to have a $25 setup fee added on their first bill. All CUSTOMERS shall also be required to post a minimum $200 deposit. CUSTOMERS that sign up for ACH Autopay will have the deposit waived. In the event that CUSTOMER cancels ACH Autopay or has a payment rejected for any reason CUSTOMER will immediately be required to post a $200 deposit, will be taken off of ACH Autopay, and may have utilities shut off.
Would you like to enroll in ACH Autopay and have the $200 deposit waived?*
Over 85% of residents choose to enroll in ACH Autopay.
Amount Due for Utility Deposit - Card Information Required Later
Customer Authorization for ACH Autopay
Authorization Agreement

I hereby authorize Spanish Fork City Corp. to initiate automatic withdrawals from my account at the financial institution named below. I understand that payment will be deducted from my account on the due date of each month or the following business day if the due date is on a weekend or holiday.

I understand that I am responsible to pay a returned item fee as specified by the City for any automatic debit that is returned to Spanish Fork City for any reason. In addition, I understand that I will be removed from automatic withdrawals and that a $200 deposit will be required.

Further, I agree not to hold Spanish Fork City Corp. responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in withdrawing funds from my account.

This agreement will remain in effect until Spanish Fork City Corp. receives a written notice of cancellation from me or my financial institution, or until I submit a new/updated ACH Autopay form to Spanish Fork City.

I understand that if I make a payment using another payment method (i.e. in office with cash or check or online with a card) after the 20th of the month, my automatic payment may still be deducted on the due date by Spanish Fork City and I assume responsibility for any bank/credit union fees that may result.
I understand that if I have an ACH Autopay payment returned that I will be removed from ACH Auto Pay and the $200 deposit will be required.
Financial Institution*
Type of Account*

CheckingSavings
Routing Number*
This is always 9 digits
Account Number*
Routing Number: first 9 digits

Account Number: digits in between the routing number and the check number
Signature - Authorization to Sign Up for ACH Autopay*

Clear

Applicant Information
Set Up Date (mm/dd/yyyy)*
Date you would like utilities taken out of previous owners name and put into your name (THIS SHOULD BE THE CLOSING DATE IF YOU ARE PURCHASING THE PROPERTY). Please sign in NO more than 1 month in advance.
Applicant Name*

First NameMiddle NameLast Name
Would you like to add someone as a Joint Applicant (i.e. spouse, etc.)?*
If you would you like anyone else (i.e. spouse, etc.) to be able to make inquiries & changes to your utility account you need to add them as a Joint Applicant.
Joint Applicant (Account info can only be given to individuals listed on this application)*

First NameMiddle NameLast Name
Service Address*
Apartment/Unit Number
Is Mailing Address Same as Service Address?*
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number - Used to contact you to confirm your account has been set up*

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number
E-mail*
example@example.com
Applicant - Social Security #*
Last 4 of Social Security #*
Applicant - Birth Date (mm/dd/yyyy)*
Identification Type*
Identification Expiration Date (mm/dd/yyyy)*
State ID Number*
State Issuing ID*
Drivers License Number*
State Issuing Drivers License*
If you do not have a United States Driver's License, State ID, or U.S. Passport, please stop filling out this form. Please call the utility office at 801-804-4500 for assistance.
Passport Number*

Applicant Employer and Emergency Contact Information
Employer Name*
If self, list business name. If Retired, type Retired, If Unemployed, type Unemployed.
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer Phone Number

Area CodePhone Number
Emergency Contact - Name of Closest Relative not living at this address*
Emergency Contact - Relationship*
Emerg. Contact - Phone*
Emerg. Contact - Address (Street Address, City, State, Zip)*

Joint Applicant/Agent Information
Joint Applicant Last 4 of Social Security #*
Joint Applicant Phone Number*

Area CodePhone Number
Joint Applicant Email*
example@example.com
Joint App. State ID/Drivers License #*
Joint Applicant - Social Security #
Joint Applicant - Birth Date (mm/dd/yyyy)*
Joint Applicant Phone Number*

Customer Type
Customer Type*
Previous Owner/Builder/Lender*
Landlord Name*
Landlord Phone Number*
Would you like Utilities to be left on when your tenants terminate their Utility Account?*
LANDLORD AGREEMENT FOR CONTINUED SERVICE

COME NOW, Spanish Fork City, a Municipal Corporation of the State of Utah, hereinafter CITY, and Property Owner listed above, hereinafter PROPERTY OWNER, who recite and agree as follows:

1. CITY supplies utility service to property belonging to PROPERTY OWNER located at rental property address(es) indicated above.

2. PROPERTY OWNER rents the property to other individuals and desires that the person or persons renting the property from PROPERTY OWNERS be responsible to pay utilities utilized by them.

3. The foregoing notwithstanding, in the event the premises are vacated, PROPERTY OWNER desires that utility service not be terminated but continue until a substitute tenant or entity contracts with the CITY for the provision of utility services.

4. It is therefore agreed that in the event any service contract for the provision of utilities at the above address is terminated for any reason that the undersigned shall immediately become responsible for the payment of utilities provided to the address at the rates and in accordance with the regulations as established by the Spanish Fork City Council, including the minimum charges for all utility services, PROPERTY OWNER shall have the right to avoid minimum utility service charges only by requesting the CITY to terminate utility service to the premises. If PROPERTY OWNER's Landlord account is past due and a tenant of PROPERTY OWNER tries to sign in for utilities, the tenant will not be allowed to sign in until PROPERTY OWNER's Landlord account is paid current.

5. The City requires free unobstructed access to all utility meters at all times.

6. CITY agrees that upon termination of the service contract, utility bills will be sent by United States Mail postage prepaid, to the PROPERTY OWNER at the Property Owner's Mailing Address shown earlier in this document.

7. Notice of termination of the contract and the establishment of a new account with an accordance with this agreement shall be sent upon termination to the address provided in paragraph 6, preceding by United States Mail postage prepaid. Notice shall be complete upon mailing.

8. It shall be the duty of PROPERTY OWNER to notify CITY of any change of address to be used for the purposes specified in paragraphs 6 and 7.

9. In the event payment is late, a 5% late fee will be assessed. There will be a charge on all returned checks in the maximum amount allowed by state law, and PROPERTY OWNER agrees to pay the same. Utility service is subject to city ordinances and policies established by the Spanish Fork City Council.

10. In the event that an account is placed with a collection agency for collection, PROPERTY OWNER shall be responsible for all collection costs incurred including a collection fee of up to 40%, pursuant to the provisions of Utah Code Ann. §12-1-11.

11. PROPERTY OWNER hereby warrants and affirms that the information provided on this form is true and correct to the best of their knowledge. FAILURE TO PROVIDE TRUE AND ACCURATE INFORMATION MAY SUBJECT YOU TO CRIMINAL PROSECUTION UNDER UTAH CODE §76-8-504. PROPERTY OWNER affirms, understands, and agrees to comply with the provisions of this agreement.

By signing the RESIDENTIAL UTILITIES CONTRACT which is also part of this form you are also agreeing to the terms set forth in this LANDLORD AGREEMENT FOR CONTINUTED SERVICE.
If Fiber Internet is not already installed at this location do you want to authorize it to be installed?*
Landlord Authorization for Fiber Installation

Spanish Fork Community Network is excited to announce that Fiber Internet is now being installed throughout the city. Offering a 1 gigabit download and upload speed, the new network will meet every customers most demanding needs. SFCN doesn't just bring fiber to your home, we will bring the fiber INTO your home; No PON, GPON or RFOG, we are building the fastest, most reliable and upgradable active ethernet system possible. There's nothing faster, nothing better! Our most popular and reliable method is to run fiber directly into the home or apartment. This usually consists of running a fiber optic cable on the outside of the residence and then drilling a hole where the customer needs their internet connection. Although our installers do the best they can to ensure the cable is neatly secured to the building, there is a chance that at some point the fiber cable will be visible on the outside of the home or apartment building. Because of this potential drawback SFCN needs written permission from the owner/landlord to run fiber optic cable on the outside of the building.
Address of all Rental Properties you want to Authorize Fiber Installation
Landlord Signature Authorizing Fiber Installation*

Clear

Spanish Fork City - Residential - Utilities Contract
SPANISH FORK CITY, a Municipal Corportation of the State of Utah and Applicant listed above hereinafter CUSTOMER do agree as follows:

1. City will provide the following services to CUSTOMER at the service address previously indicated on this Utility Contract: Mandatory Services (please note your Landlord or HOA may pay for some of these services): Residential Electric, Pressurized Irrigation (may be exceptions), Storm Drain, Culinary Water, Sewer, Garbage. Services shall be provided in accordance with State law and municipal ordinances and resolutions as requested on the setup form at rates as established by ordinance or resolution of the Spanish Fork City Council provided that city shall not be responsible for failure to deliver services by reason of strikes, accidents, acts of God, weather conditions, natural disasters - whether declared or undeclared, state or other governmental regulations or any other act, contingency of bar beyond city's control.

2. CUSTOMER shall pay such fees and deposits as shall be established by the city and shall further be subject to termination of services upon non-payment or failure to comply with rules, regulations, ordinances or laws as established by the city. CUSTOMER acknowledges and agrees to pay minimum water charges, and minimum electric charges, even in the event that the premises are vacant for extended periods of time, provided that CUSTOMER may eliminate minimum electric and water charges only by requesting the city to terminate service. In such event, CUSTOMER agrees to pay a reinstatement fee, as set by the city, to restore electric power service and water services. Utility deposits will be held without interest for an indefinite period of time. CUSTOMER agrees to be bound by the utility policy of the city and also the terms and conditions of the Rate Schedule and to pay applicable rates as established by the city council. The utility deposit is held until the CUSTOMER moves. At that time, it will be applied to the account, and any unused portion will be refunded. A CUSTOMER who fails to post a deposit when requested is subject to termination of service. In the event payment is late, a 5% late fee will be assessed. There will be a charge on all returned checks in the maximum amount allowed by state law, and CUSTOMER agrees to pay the same. Utility service is subject to city ordinances and policies established by the Spanish Fork City Council.

3. The City requires free unobstructed access to electric, water and pressurized irrigation meters at all times.

4. In the event this account is placed with an attorney for collection, either with or without suit, CUSTOMER shall be responsible for all court costs and reasonable attorney's fees incurred thereby.

5. In the event this account is placed with a collection agency for collection, CUSTOMER shall be responsible for all collection costs incurred including a collection fee of up to 40%, pursuant to the provisions of Utah Code Ann. §12-1-11.

6. CUSTOMER , if any, hereby warrant and affirm that the information provided on this set up form is true and correct to the best of their knowledge. FAILURE TO PROVIDE TRUE AND ACCURATE INFORMATION MAY SUBJECT YOU TO CRIMINAL PROSECUTION UNDER UTAH CODE S76-8-504. Customer also affirm, understand, and agree to comply with provisions of this utility contract.

7. Federal law requires that we establish your identity by accessing information in your credit report. By submitting this application you are authorizing us to obtain information from your credit report to validate your identity.
Applicant Signature Agreeing to Utilities Contract*

Clear
Security Question*
To verify your identity when making future inquiries about your account the answer to a Security Question may be required.
Security Question Answer*

Utility Assistance Donations
The Utility Assistance Program is a voluntary program that helps low-income individuals and families with their utility bills. We place 100 percent of your donation into a fund that is exclusively used for low-income utility assistance in Spanish Fork. If you decide to participate we will round your utility bill up to the nearest dollar each month. The difference will go to the Utility Assistance Program.

The program is administered by Community Action Services and Food Bank located in Provo.

For example if your total bill comes to $199.25 your bill will be rounded up to $200 with 75 cents being donated to the program.
Would you like to donate to the Utility Assistance Program that goes to help low-income Spanish Fork residents pay their utility bill?

No, I would not like to donate.Yes, please round my utility bill up each month to the nearest dollar and contribute the difference to the Utility Assistance Program.

Previous Account with Spanish Fork City
Do you need to have your current Spanish Fork Utilities disconnected? *
If you are moving within Spanish Fork and would like to cancel your current utility account please select yes.
Street Address for SF Utility Account that you would like disconnected*
Date you would like old SF Utility Account disconnected (terminated) (mm/dd/yyyy)*
Have you and/or your spouse ever had an account with the City?*
If you have a prior account that has a past due balance the past due amount as well as any collection fees will need to be paid in full before services will be provided at the new location. Please call 801-804-4597 to make a payment on the prior account.
Name & Address on previous account(s) *
If have never had account with SF City type N/A in box

Spanish Fork City Library
Spanish Fork City Library is located at 80 South Main. Residents may use the library at no cost. If you sign up for a library card, library staff will contact you to complete your account.

Additional Library Information

Library User Agreement

I understand that I am responsible for all material checked out on the card(s) associated with this application, whether by myself or anyone else. I agree to pay the replacement costs for any lost or damaged materials, including attorney's fees, administrative fees, and cost incurred by the city in collecting or recovering these costs.
Would you like to sign up for a library card? Provided free to residents.*

Yes, I agree to the library user agreement.No, not at this time.

Pay Cashier This Amount

Useful Information

A utility office employee will call you in the next few business days to confirm information such as garbage and SFCN services and answer any questions

City ordinance requires that all new utiity accounts must have a recycle can for a minimum of six months.

Spanish Fork City does not provide natural gas service. Call Dominion Energy at 800-323-5517 to set up your account with them.

To see what services the city provides and their rates click here.

To find out what day your garbage will be collected click here.
Please review Spanish Fork City's Privacy Policy Statement before submitting this form.

Spanish Fork City’s Privacy Policy Statement
For Office Use Only
( ) Save New Application

( ) Create & Terminate Out

( ) Verify All (could be 5) Signatures on Application

( ) Review

( ) Verify Payment Received & Check Square

( ) Payment History - LastName%FirstName

( )Terminate Old Account: N/A ( ) Yes ( ) No ( )

( ) Verify # of Cans w/ Customer and in Caselle

( ) Contact Customer

( ) Setup in Caselle

( ) Review Caselle Setup

( ) Save to Final Destination

( ) Delete in Jotform

Date of Deposit _____________________________
Should be Empty:

Set Up Fee & Deposit

Customer Authorization for ACH Autopay

Applicant Information

Applicant Employer and Emergency Contact Information

Joint Applicant/Agent Information

Customer Type

Spanish Fork City - Residential - Utilities Contract

Spanish Fork Community Network Services

Broadband Facts

Spanish Fork Community Network

PLUS

Monthly Price $45

Additional Charges & Terms

Provider Monthly FeesNone

One-time Fees at the Time of PurchaseNone

Early Termination Fee None

Government Taxes Included

Discounts & Bundles

Speeds Provided with Plan

Data Included with Monthly Price Unlimited

Customer Support

Broadband Facts

Spanish Fork Community Network

Premium

Monthly Price $75

Additional Charges & Terms

Provider Monthly FeesNone

One-time Fees at the Time of PurchaseNone

Early Termination Fee None

Government Taxes Included

Discounts & Bundles

Speeds Provided with Plan

Data Included with Monthly Price Unlimited

Customer Support

Utility Assistance Donations

Previous Account with Spanish Fork City

Spanish Fork City Library

Credit Card