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Owner's Consent Form

Fortis TCI Owner's Consent Form
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Owner’s Consent Form
To Be Completed By Property Owners/Managers

NOTE: Below required information must be provided and correct in order for the customer to receive timely service. If you are not the owner, but act on behalf of or manage the property please provide proof of authorization from the owner to act on his/her behalf. This form must be accompanied by a copy of a photo ID of the property owner or manager

Date:
Meter # *:
(If service is existing)
Preferred language*:
Type of property:
This advises that: Mr./ Mrs./ Miss. *:
(Name of tenant)
Island*:
Is the tenant at *:
(Please provide the 911 issued address)
HE/SHE/THEY began tenancy as of *:
(Initial date of lease/agreement)
This residence/unit was previously occupied by:
(Name of previous tenant)
Upload File:
The above information provided is said to be true and correct.
I *
(Print name of: Property Owner/Manager)
am the legal proprietor/agent of the above mentioned property.
Contact #:
Signature *:
Secondary person name:
Secondary Signature:
Email address*:
Date:

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