Lompoc, CA · Santa Barbara County
Third-Party Notification
Lompoc utility customers use this form to designate someone to receive notices about planned service interruptions or disconnection for nonpayment.
What this form is
This form lets a Lompoc utility customer designate a third party to receive duplicate notices about planned water or electricity interruptions and disconnection for nonpayment. The document says customers aged 65 or older or dependent adults may request delinquency and impending-termination notices in writing. It asks for the customer’s and designee’s names, addresses, telephone numbers, account number, signatures, and dates.
Who needs it
A Lompoc utility customer who wants a designated third party to receive notices about planned interruptions or possible disconnection can complete this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed and dated without a notary; it identifies no attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download the Form
Download the Third-Party Notification form for Lompoc utility customers.
- 2
Complete Customer Details
Enter the customer’s name, address, telephone number, and utility account number.
- 3
Add Third-Party Details
Enter the designee’s name, address, and telephone number.
- 4
Sign and Date
The customer and designated third party sign and date the form.
- 5
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Third-Party Notification form?
- No. The form asks the customer and third party to sign and date it; it identifies no attachment or related step that must be notarized or sworn.
- How do I submit the Third-Party Notification form?
- The form does not specify submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
- What notices can a third party receive?
- The designated person may receive duplicate notices about planned interruptions to water or electricity service and disconnection for nonpayment.
- Does the designated third party have to pay my utility bill?
- No. The form states that the designee is under no obligation to pay the bill and that the customer remains responsible for paying on time.