Multi-unit declaration of domicile for purchase of residential utilities

We ask that you complete the entire form. All fields marked with an asterisk (*) are required.

This Multi-Unit Declaration of Domicile is for landlords or other persons holding a single account with a utility provider or rural electric cooperative which serves multiple dwelling units.

Landlords or other accountholders should submit a Multi-Unit Declaration of Domicile for each meter that serves multiple units; however, every unit served by the meter must have a fully-completed Declaration of Domicile for the account to qualify as residential. Landlords or other accountholders may not complete the Declaration of Domicile on behalf of their residents.

Accounts for meters that exclusively serve common areas or that serve common areas and multiple dwelling units are not eligible for residential treatment. No declaration shall be submitted for these accounts.

The change in taxability for accounts will be effective on the first day of the first full billing cycle after the date of receipt of this Multi-Unit Declaration of Domicile by the utility provider or rural electric cooperative.
If we need to contact you for additional information, please provide your phone number and email address.


Under penalties of perjury, I swear or affirm that the declarations I am submitting with this form include 100% of the dwelling units at the service address below.