Home Request for Reconnection of Water

2. Water Service Information
   I request the reconnection of water at the following address from the City of Rio Rancho (this is a HUD, Foreclosure, Repossessed Home, or Short Sale Property)

   I request the reconnection of water at the following address from the City of Rio Rancho (this is a HUD, Foreclosure, Repossessed Home, or Short Sale Property)

4. Service Address:*

   Address, City, State, Zip

5. Requested Turn on Date *
   Requested Turn on Date

6. For:*

   1. Non - Payment
   2. New Service
8. I will be present or have a responsible party present during the time of:*

   1. 8:00 A.M - 12:00 P.M
   2. 1:00 P.M - 5:00 P.M

12. Applicant Information

14. Name:*

15. Phone:

19. Ordinances
    Section 51.09 - Discontinuance, denying, and restoration of service: The utility reserves the right to schedule restoration of utility service on the day following payment of balance due.

    Section 51.09 - Discontinuance, denying, and restoration of service: The utility reserves the right to schedule restoration of utility service on the day following payment of balance due.

23. Acknowledgement and Signature
    I understand that if there is no one present during the time that I have requested the reconnection to be completed, I will have to call the office to re-schedule the reconnect. This may delay the reconnection to be completed on the next business day.

    I understand that if there is no one present during the time that I have requested the reconnection to be completed, I will have to call the office to re-schedule the reconnect. This may delay the reconnection to be completed on the next business day.

25. Signature:*

26. Date:*
    Date:

Leave This Blank:


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