Real Estate Utility Billing Form

Please complete the following utility billing form accurately to ensure your utility usage is correctly recorded and billed. If you have any questions or require assistance, please contact our management office.

Property Information

Property Name
Address
Unit Number		Tenant Name

Billing Period: From                                To                               

Utility Usage

	Meter Reading Start	Meter Reading End	Total Usage	Rate	Amount Due
Electricity
Water
Gas
Waste Removal	NA	NA	NA
Total Amount Due

Payment Due Date:                               

Tenant Acknowledgment

I,                                (tenant name), acknowledge the accuracy of the above utility usage and agree to the total amount due as calculated. I understand my payment obligations and the consequences of late payments as outlined above.

[Date]

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