Residential utility service for multi-unit rental facilities with separate meters (including Mobile Home and RV Parks)

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

This Multi-Unit Separate Meter Declaration of Domicile is for owners or operators of multi-unit residential rental facilities, mobile home parks, or recreational vehicle (“RV”) parks used by Kentucky residents as their place of domicile. Submit this form for each separate metered account under the owner or operators name, that measures utility service to each rental unit.

Common Areas - Do not submit this form for any meter that measures utility service exclusively for the common area(s) of a multi-unit residential rental facility, mobile home park, or RV park (i.e., parking lot lighting, hallway lighting, common laundry room, etc.). Accounts that measure service exclusively to common areas of separately metered multi-unit residential rental facilities, mobile home parks, or RV parks are NOT eligible for the residential sales tax exemption.

Common Areas – Do not submit this form for any meter that measures utility service to both residential units and common areas if the common area usage is greater than 10% of the total usage measured by that meter. These accounts are NOT eligible for the residential sales tax exemption.

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 Separate Meter 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.