Property/Owner information
Property address : •
City: •
State: •
Zip code: •
Date property purchased/sold: •
Date billing responsibilities changes: (If different than purchased/sold date)

Seller
Seller/Legal entity name:
Project/Division name (if applicable):
Seller’s mailing address:
City:
State:
Zip code:
Seller’s phone:
Fed. tax ID/SSN:

Purchaser
Purchaser/Legal entity name:
Project/Division name (if applicable):
Purchaser’s mailing address:
City:
State:
Zip code:
Purchaser’s phone:
Fed. tax ID/SSN:

Purchaser, please complete the following information

Sales tax exemption
You may be exempt from paying state sales tax on utility charges if you purchase electric, natural gas or steam services for residential use between November and April. Residential use includes services for common areas and/or individual units in residential-use buildings. Would you like us to send you paperwork to apply for a sales tax exemption?
Yes      No

Owner agreement options
Indicate responsibility for energy service(s) by selecting one of the following options. (Review Disconnection Rules below prior to making your selection.)

Option 1 — All year agreement
I accept billing responsibilities for energy service between tenants. B selecting this option, I will be billed for all energy usage between tenants unless I notify your company otherwise.

Option 2 — Lock/disconnect agreement
I do not want to assume billing responsibility between tenants. I request We Energies terminate service to the rental dwelling unit. I affirm that service termination will not endanger human health or life, or cause damage to property.

Option 3 — No permanent agreement
I do not want a permanent agreement. I understand that you will notify me a each tenant change and ask me to select whether I want energy service place in my name or disconnected. I understand that I will need to provide We Energie with my response within 15 days of the notification to avoid being billed for energy service.

Please mail the bills to:
Purchaser’s mailing address shown above or
Address listed below:

Mailing address
Street address:
City:
State:
Zip code:

Disconnection rules

• If you choose to have service disconnected and the meter(s) are located inside the building or are otherwise inaccessible, you will
  need to provide access for our metering staff to disconnect the service(s).
• Under Public Service Commission of Wisconsin rules for cold weather disconnections, we are required to verify that residential
  premises are vacant before disconnecting natural gas and electric service between November 1 and April 15.
• From November 1 through April 15, we will need access to both the living unit and the meter(s) in most cases.
• Arrangements for access to the unit and/or meter(s) must be made within 15 days of the notification of a tenant’s move in order to avoid being billed for energy services.

Please list other residential properties you own that you would like to include in this agreement:

Property management company information (if applicable)
Company name:
Company mailing address:
City:
State:
Zip code:
Company contact name:
Contact e-mail address:
Contact phone:
Company fax number:
Tax ID/SSN:

Completer Signature: •
Completer Email: •
Date: •