Ventana Service Request

Service Request

Ventana Metropolitan District
Professionally Managed by

WSDM, LLC

614 North Tejon Street

Colorado Springs, CO 80903

Instructions: Please fill out this application in its entirety and email a completed copy to Amber.H@WSDistricts.co. to request new service or a change in service. This Service Request facilitates the creation of a billing account in your name, as such your Social Security Number (SSN) is required and will be used for identification purposes. If you prefer not to provide your SSN, your application may be submitted in person, at the Management office, with identification presented and verified. Applications for service are typically processed within five (5) business days from the date of receipt. Incomplete forms will be denied, and resubmittal required. Accounts are held by the Owner of real property within the community boundaries, not by tenants or third parties. If the property is not Owner occupied, the tenant(s) or other third-party property managers may be listed as additional contacts on the account.

Contact Management at (719) 447-1777 with questions regarding or for assistance with completing this form.
Check one of the following*

Owner OccupiedRental Property
Your Name*

First Name'Legal Last Name
Your Phone Number*
Property/ Owner(s) Information
Service Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Phone Number
Closing/Move in Date*

MonthDayYear
Date
Would you like to sign up for email billing?*

YesNo
Email
example@example.com
Name of Landlord/ Property Manager/ Owner (Printed)
Landlord/Property Manager/Owner Signature

Clear
Social Security Number (last four digits)*
Date of Birth*

MonthDayYear
Date
Previous Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact (residing in the United States, over the age of 18)
Name*
Phone Number *
Service Request*

Transfer of Service - $40Other ( Please Explain)
I hereby certify that I have read the information on this form and understand its contents, and that the statements I have made are accurate to the best of my knowledge.
Applicant Signature*

Clear
Date*

MonthDayYear
Date
If you choose to email your application, you willingly accept all risks related to intercept, misaddressed, misdelivered or otherwise unsecured transmissions.

Customer Service: Mon. -Fri. 8:00 a.m. to 5:00 p.m.
Address: 614 North Tejon St. Colorado Springs, CO 80903
Account Number
Approved Date

MonthDayYear
Date
Notes
Should be Empty: