St. Louis, MI · Gratiot County
Extension for Time to Pay Utilities – Renter
Renters use this form to request more time to pay utility amounts subject to shutoff and document a payment promise with landlord acknowledgment.
What this form is
This form lets a renter request an extension to pay utility amounts subject to shutoff. The form says to file before shutoff and requires landlord acknowledgment; it also asks for renter and landlord contact details, amounts owed, a payment plan, and signatures. It warns that extensions cannot be granted two months in a row and that missed promised payments prevent further extensions for 12 months from default.
Who needs it
A renter seeking more time to pay utility amounts subject to shutoff needs to complete the form and obtain the landlord’s acknowledgment.
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 document is signed without a notary; the renter and landlord sign and date their acknowledgments, with no notarized or sworn attachment listed.
How to submit this form
- 1
Download The Form
Download the Extension for Time to Pay Utilities – Renter form.
- 2
Complete The Form
Enter your contact information, amounts subject to shutoff, and proposed payment amounts and dates.
- 3
Get Landlord Acknowledgment
Have your landlord acknowledge and give permission for the requested extension by signing and dating the form.
- 4
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
- What is the Extension for Time to Pay Utilities form?
- It lets a renter request more time to pay utility amounts subject to shutoff and state a payment plan, with acknowledgment from the landlord.
- Who needs to complete this renter utility extension form?
- A renter requesting an extension for utility amounts subject to shutoff completes the form. The landlord must acknowledge and give permission for the requested extension.
- Do I need a notary for the Extension for Time to Pay Utilities form?
- No. The renter and landlord sign and date their acknowledgments; the form lists no notarized or sworn attachment.
- How do I submit the renter utility extension form?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Extension for Time to Pay Utilities – Renter doesn’t need a notary — but Michigan residents can notarize other documents online with a commissioned online notary.