RRMD Service Request Form

Service Request

Remuda Ridge Metropolitan District - c/o WSDM Managers 3204 N. Academy Ste. 100 Colorado Springs, CO 80917
Instructions: Please complete this application in its entirety and it will be forwarded to our administrative team. 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. Please call the office at 719-447-1777 during regular business hours Monday through Friday, 8:00 a.m. to 5:00 p.m. for assistance. If you do not wish to provide your SSN, you may bring your application to our office location at 3204 N. Academy Blvd. Ste. 100, Colorado Springs, CO 80917. It is the tenant's responsibility to notify the District Manager when moving from this location. All accounts will be set up and remain with property owners, tenants or other third-party managers may be listed as contacts.
Check one of the following*

Rental PropertyOwner Occupied
Property/Owner(s) Information
Service Address
Closing/ Move in Date

MonthDayYear
Date
Name of Landlord/ Property Manager (Printed)
Email
example@example.com
Please indicate if you would like your bills sent to the email you provide. Doing so, youEmail: will not receive a paper bill in the mail.*

YesNo
Landlord/ Property Manager/ Owner Signature

Clear
Contact Phone Number:*

Area CodePhone Number
Resident Information
Name*

First NameLegal Last Name
Social Security Number (last four digits)*
*Date of Birth*

MonthDayYear
Date
Previous Address*
Phone Number*

Area CodePhone Number
Mailing Address (if different from service address)*
Third Party Notification

Third Party Notification I authorize the District Manager to send a duplicate notice of late payment to the landlord/ property manage
Customer Signature

Clear
Emergency Contact

(residing in the United States, over the age of 18)
Name

First NameLast Name
Phone Number

Area CodePhone Number

Service Request

Property/Owner(s) Information

Resident Information

Third Party Notification

Emergency Contact

For Office use only: