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Tenant Authorization Online Form

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This is a form you can complete online and then email directly to the appropriate staff member at the City of Kalama. If you would prefer to print and complete the form to send to the City offices, click here.

Please correct the field(s) marked in red below:

Form must be filled out completely.

1

Date:

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2

I verify I am the tenant of the property located in Kalama, Washington at:

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3

I understand I will be receiving and paying the City of Kalama utility bills for the above property.  I understand if I am delinquent, a copy of the late notice will be sent to my landlord.  If I am unable to pay the balance in full when it becomes due, I am to contact the landlord with proposed payment arrangements.  If the landlord agrees to the terms, the landlord will contact the City of Kalama with the proposed arrangements and indicate approval.

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4

Tenant Address

5

Tenant Phone Number

6

Tenant Cell Phone Number

7

Tenant Email

By submitting this form, you acknowledge that you have read and understood the agreement and agree to all its terms and conditions. You furthermore acknowledge that you have the authority to make this agreement.

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