Equal Payment Plan

Equal Payment Plan
Do you own the property?*
ONLY THE PROPERTY OWNER IS ELIGIBLE TO APPLY FOR OR TERMINATE THE EQUAL PAYMENT PLAN. DO NOT FILL OUT THIS APPLICATION IF YOU ARE RENTING. If you have additional questions please call 801-789-6609 or email utilitybilling@eaglemountain.gov
Equal Payment will help even out the highs and lows of your monthly bill for easier budgeting.

How Equal Payment works:
- You are eligible to apply for Equal Payment if you Own the property and your utility account has been open for at least 13 months. The account must be in good standing without any overdue balance.
- Only the Water Usage amount of your monthly bill is eligible for an equal payment plan. All other services will be billed at their regular monthly amount.
- We will average your last 12 months of Water Usage to determine your Equal Payment amount.
- Your plan is reviewed at least annually to compare the estimated amount to your actual usage and the plan amount will be adjusted.
- We will also montior your plan year-round and sometimes make changes mid-year to the plan amount to ensure you do not have a large amount owing at the end of the annual review period.
- Plan amounts may be adjusted to reflect changes to utility rates in the cities published consolidate fee schedule.
- If the plan is cancelled for any reason any difference will be billed or credited to your account. The plan will be cancelled if your account becomes subject to shutoff for non-payment or has returned payments.
General Information:
- Fields with a Red Asterik * must be completed
- A valid photo ID is required on the form. Please upload a copy when prompted.
- Please note it will take three to five business days for the application to be reviewed and an estimate plan amount to be calculated and emailed to you.
- You must accept the proposed plan amount before it will be activated.
- If approved Equal Payment will reflect on the next billing period.
Important*

All Information provided as part of this form will be store by a third-party service provider. If you do not wish to provide personal information such as your ID on the JotForm site, we require that you provide them in person at the Utility Billing Office. To view details regarding the security measures put in place by JotForms, please visit: https://www.jotform.com/secuirty
OFFICE USE ONLY

Property Owner Information
What are you requesting?*
Your Name*

First NameLast Name/Business Name
Utility Account Number
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Service address*

Street Address

Street Address Line 2

CityState

Zip Code
Valid Driver's License # or Tax EIN#*
State*
Select the issuing state for your driver's license or if a business the state that the business is registered in.
For residential requests please attach a photo of the front of your valid driver's license. If you are a business attach a copy of your TAX EIN #*

Cancelof

The undersigned applicant hereby applies to Eagle Mountain City, a municipal corporation of the state of Utah (referred to as the City), for utility services from the City to the above lot number, in the above subdivision or to the property at the address listed above.

The Applicant agrees to pay all utility service charges and other related fees and charges to the City in full as they become due. The timely payment to the City of all required fees and charges is a condition for the continued service of all utilities to the property described above. The applicant hereby agrees to comply fully with all ordinances, rules and regulations in force at the date of this agreement or to be enacted in the future by the City for utility services.

This agreement is executed by the Applicant as property owner. By accepting the services from utilities furnished by the City under this agreement, the property owner and Applicant agree to be bound by the terms of this Agreement.

I agree that late fees and/or interest in the amounts adopted by Eagle Mountain City will accrue on all past-due amounts until paid in full. In the event that any amounts are referred to a third party debt collection agency, I agree that in addition to any other amounts allowed for by law, such as interest, court costs, and reasonable attorney's fees, I will also be responsible for collection fees in the amounts owing as allowed by Utah Code Ann. § 12-1-11. The terms of this paragraph shall apply to all amounts incurred by myself of by any individual that has legal responsibility for this account whether such amounts are incurred today or after today.

I, the undersigned, hereby certify that the information given is true and correct.
Name*

First NameLast Name
Date*

MonthDayYear
Date
Signature*

Clear
OFFICE USE/ACCEPTANCE ONLY
Reviewed By (Name or Intials)*
Reviewed Date*

MonthDayYear
Date
Application Status*

Proposal SentApprovedDeniedEqual Pay Plan Terminated
Reason For Denial
If Other selected specify reason(s) here
Equal Payment Water Usage Proposal Amount*
12 month average for water usage only
By signing below you are agreeing to the proposed equal payment plan amount list above for water usage charges and acknowledge the amount may be periodically reviewed and adjusted to prevent large balances from accruing. Payments must be made by the due date each month for the equal pay amount plus any other additional services or fees on your monthly bill maintain enrollment in the plan.

Clear
Approval Date

MonthDayYear
Date
Should be Empty:

Equal Payment Plan

Property Owner Information

OFFICE USE/ACCEPTANCE ONLY