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Address Change Request Form

DATEmm/dd/yyyy

ACCOUNT NUMBERUSE DASH IN ACCOUNT #

SERVICE ADDRESS

OWNER NAME

ADDITIONAL OWNER NAME

OWNER ADDRESS

OWNER CITY AND STATE

OWNER ZIP CODE

OWNERS PHONE NUMBER

OWNER EMAIL ADDRESS

OWNER EBILL ENROLLMENTMUST SELECT ONE

YESNO

OLD TENANT NAME

NEW TENANT NAME

TENANT ADDRESS

TENANT CITY AND STATE

TENANT ZIP CODE

TENANT PHONE NUMBER

TENANT EMAIL

TENANT EBILLMUST SELECT ONE

YESNO

PLEASE SELECT OPTION BELOW

Owner Address Change
Duplicate bill sent to Tenant [one of the bills must be received electronically. Chose Owner or Tenant above to receive E-Bill]
New Tenant Information
Tenant Removal

As a courtesy the Deptford Township MUA may add a tenant to receive a duplicate bill at the owner’s request, but the property owner is ultimately responsible for any water and/or sewer charges according to N.J.S.A. 40:14b-21 and N.J.S.A. 40:14b-22 and a Township tax lien may be levied against the property for unpaid charges. The MUA will not become involved with any tenant/landlord issues.

Check Box