Sebastopol, CA · Sonoma County
Advanced Metering Infrastructure (AMI) Opt-Out Program Application
Residential customers use this application to request that the City of Sebastopol deactivate advanced metering infrastructure at their water service address.
What this form is
The application requests manual monthly water meter readings instead of installing the data collector or transmitter with the meter. Residential customers complete both sections with account and contact information, customer-of-record details, and signed acknowledgements. The application states that the property owner must approve a tenant’s request, and the customer’s certification is made under penalty of perjury.
Who needs it
Residential customers who prefer not to have the AMI data collector or transmitter installed with their water meter use this application.
How to submit it
Return the original signed application to the City of Sebastopol, 7120 Bodega Ave., Sebastopol, CA 95472. Digital and facsimile copies will not be accepted.
About notarization
This application has no notary block; the customer signs and dates it, and the owner’s information certification is submitted under penalty of perjury.
How to submit this form
- 1
Download The Application
Download the AMI Opt-Out Program Application PDF.
- 2
Complete Both Sections
Fill in customer, account, service address, and contact details, then complete the acknowledgements in Section B.
- 3
Sign And Date
The customer of record signs and dates Section B. For a tenant-occupied property, the owner’s approval and signature are required.
- 4
Return The Original
Mail or deliver the original signed application to the City of Sebastopol at 7120 Bodega Ave., Sebastopol, CA 95472; digital and fax copies are not accepted.
Frequently asked questions
- What does the AMI Opt-Out Program Application request?
- It asks the City of Sebastopol to deactivate advanced metering infrastructure at the identified water service address so the meter can be read manually each month.
- Who must complete the application?
- Residential customers seeking to opt out complete both sections. For a tenant-occupied property, the property owner must acknowledge and approve the tenant’s request.
- Do I need a notary for the AMI Opt-Out Program Application?
- No. The application has no notary block; the customer signs and dates it, and the owner’s information certification is submitted under penalty of perjury.
- How do I submit the AMI Opt-Out Program Application?
- Return the original signed application to the City of Sebastopol at 7120 Bodega Ave., Sebastopol, CA 95472. Digital and facsimile copies are not accepted.