Heath, OH · Licking County
Direct Billing Agreement
This agreement lets a property owner authorize a tenant to receive and pay water and wastewater bills for a Heath service address.
What this form is
The property owner completes this agreement to authorize water and wastewater bills for a service address to be mailed directly to a tenant. The form says it must be signed and returned to the Heath Water Office before water services are received. It asks for the service address, move-in date, contact and account details, and signatures from the property owner and tenant.
Who needs it
Property owners who want a tenant to receive and pay water and wastewater bills for a Heath service address should complete this agreement with the tenant.
How to submit it
Mail or drop off the completed, signed form to the Heath Water Department at 1287 Hebron Rd., Heath, OH 43056, or scan and email it as a PDF to [email protected].
About notarization
This agreement is signed without a notary; the document lists no notarized or sworn attachment, so the property owner and tenant sign and provide the requested details.
How to submit this form
- 1
Download The Agreement
Download the Direct Billing Agreement PDF.
- 2
Complete The Form
Enter the service address, move-in date, requested owner and tenant information, and contact details.
- 3
Sign The Agreement
Have the property owner and tenant sign the agreement.
- 4
Submit To The Water Department
Mail or drop off the signed form, or scan and email it as a PDF to the address listed on the form.
Frequently asked questions
- Do I need a notary for the Direct Billing Agreement?
- No. The agreement is signed without a notary and lists no notarized or sworn attachment; the property owner and tenant sign and provide the requested details.
- How do I submit the Direct Billing Agreement?
- Mail or drop off the signed form at the Heath Water Department, 1287 Hebron Rd., Heath, OH 43056, or scan and email it as a PDF to [email protected].
- When must I return this agreement?
- The form says it must be signed and returned to the Heath Water Office before receipt of water services.
- What information does the agreement request?
- It requests service and move-in details, owner and tenant names, contact information, the last four digits of each signer's Social Security number, and their signatures.