What does the Water & Sewer Service Acknowledgment Form do?

It records that a customer received and reviewed the City of Toledo Water & Sewer Fact Sheet, including policies on service charges, billing, discontinuation, and delinquent accounts.

Who completes this acknowledgment form?

The customer provides their name, service address, and account number, then signs and dates the acknowledgment. The form also has a signature and date line for a city representative.

Do I need a notary for the Water & Sewer Service Acknowledgment Form?

No. This form has no notary block; the customer and city representative sign and date it, and the document lists no notarized or sworn attachment.

Toledo, WA · Lewis County

No notary required

Water & Sewer Service Acknowledgment Form

Toledo property owners sign this form to acknowledge receiving and reviewing the city’s Water & Sewer Fact Sheet and its service-charge policies.

What this form is

This form records a property owner’s acknowledgment that they received and reviewed the City of Toledo Water & Sewer Fact Sheet. It asks for the customer’s name, service address, account number, signature, and date, and explains policies for base charges, billing responsibility, service discontinuation, and delinquent accounts. The form also includes a space for a city representative’s signature and date.

Who needs it

A property owner completing the city’s water and sewer service acknowledgment provides their name, service address, account number, signature, and date.

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 customer and city representative sign and date it, and no notarized or sworn attachment is listed.

How to submit this form

1
Download The Form
Download the Water & Sewer Service Acknowledgment Form.
2
Complete The Customer Details
Enter the customer name, service address, and account number.
3
Review And Sign
Review the acknowledgment, then sign and date the customer signature line.
4
Submit To The City
Submit the completed form to the city department named on it; check the city website for current contact details.

Frequently asked questions

What does the Water & Sewer Service Acknowledgment Form do?: It records that a customer received and reviewed the City of Toledo Water & Sewer Fact Sheet, including policies on service charges, billing, discontinuation, and delinquent accounts.
Who completes this acknowledgment form?: The customer provides their name, service address, and account number, then signs and dates the acknowledgment. The form also has a signature and date line for a city representative.
Do I need a notary for the Water & Sewer Service Acknowledgment Form?: No. This form has no notary block; the customer and city representative sign and date it, and the document lists no notarized or sworn attachment.
How do I submit the Water & Sewer Service Acknowledgment Form?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Water & Sewer Service Acknowledgment Form doesn’t need a notary — but if you have another Toledo form that does, a commissioned online notary can help.