Mountain Vista Service Request Form

Mountain Vista Service Request Form
Mountain Vista Metropolitan District

District Manager: Walker Schooler District Managers, LLC

614 North Tejon Street Colorado Springs, CO 80903

Instructions: Please complete this application in its entirety and email to Amber.H@WSDistricts.co. Your Social Security Number (SSN) will be used for identification purposes. Applications for utility service are typically processed within five (5) business days from the day of receipt. Denied applications will have three (3) business days to complete application requirements, denials will occur for incomplete forms turned in. You call the office at 719-447-1777, for assistance. If you do not wish to provide your SSN, we will take your application at our office location at 614 N Tejon St., Colorado Springs, CO 80903. It is the tenant's responsibility to notify the District Manager to disconnect service when moving from this location.
Check one of the following*

Rental PropertyOwner Occupied
Your Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Property/ Owner(s) Information
Service Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Contact Phone Number

Area CodePhone 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/ Property Owner
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
Is your Mailing Address different from your property address?*

YesNo
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)
Emergency Contact's Name*
Emergency Contact's Phone Number*

Area CodePhone Number
Service Request*

Transfer of Ownership AccountTransfer of Rental AccountOther
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: