EFTA00082018¶
The City of New York Department of Environmental Protection Bureau of Customer Services 59-17 Junction Boulevard Flushing, NY 11373-5108¶
Customer Registration Form for Water and Sewer Billing¶
Property and Owner Information:¶
(1) Property receiving service: BOROUGH: MANHATTAN¶
BLOCK: 1386¶
LOT: 10¶
(2) Property Address: 9 EAST 71ST STREET, NEW YORK, NY 10021¶
(3) Owner’s Name: MAPLE, INC.¶
Additional Name:¶
Affirmation:¶
Your water & sewer bills will be sent to the property address shown above.¶
Customer Billing Information:¶
Please Note:¶
A. Water and sewer charges are the legal responsibility of the owner of a property receiving water and/or sewer service. The owner’s responsibility to pay such charges is not affected by any lease, license or other arrangement, or any assignment of responsibility for payment of such charges. Water and sewer charges constitute a lien on the property until paid. In addition to legal action against the owner, a failure to pay such charges when due may result in foreclosure of the lien by the City of New York, the property being placed in a lien sale by the City or Service Termination.¶
B. Original bills for water and/or sewer service will be mailed to the owner, at the property address or to an alternate mailing address. DEP will provide a duplicate copy of bills to one other party (such as a managing agent), however, any failure or delay by DEP in providing duplicate copies of bills shall in no way relieve the owner from his/her liability to pay all outstanding water and sewer charges. Contact DEP at (718) 595-7000 during business hours or visit www.nyc.gov/dep to provide us with the other party’s information.¶
Owner’s Approval:¶
The undersigned certifies that he/she/it is the owner of the property receiving service referenced above; that he/she/it has read and understands Paragraphs A & B under the section captioned “Customer Billing Information”; and that the information supplied by the undersigned on this form is true and complete to the best of his/her/its knowledge.¶
Print Name of Owner:¶
Signature: ___ Date (mm/dd/yyyy)¶
Name and Title of Person Signing for Owner, if applicable:¶
BCS-7CRF-ACRIS REV. 8/08¶
- see above
2011122700132101¶