LandlordRevertForm | Essential Utilities

Customers

Landlord Revert Form

Aqua’s Revert to Landlord service is available to rental property owners in all states.

When a Tenant notifies Aqua they are moving out, service automatically transfers to the Owner/Landlord. There is no Activation Fee when service reverts to the Owner/Landlord.

If you are interested in setting up this service, please complete the form below.

I hereby agree that I will be responsible for all Aqua services at the following address(es) when a tenant moves out:

Owner/Landlord Name

Driver's License State

Driver’s License #

Service Address*

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

*Please put the account in my name when the tenant at the above address notifies Aqua that he or she is moving out of the property and will no longer be responsible for the service. If there are additional addresses, please enter in the box below.

Additional Service Address(es) If Needed:

Please mail this notice and/or bills to me at:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Daytime Phone Number

Illinois Owner/Landlord Only:

*Written notification will be sent to Illinois owners/landlords each time the account is placed in their name. If you do not want to be notified each time the service is placed in your name, please check this box. You can opt out of receiving notification at any time by contacting Aqua at 877.987.2782.

I understand that I can cancel this request at any time by notifying Aqua at 877.987.2782.

Owner/Landlord Signature

Please type your name to sign this form.

Date

If you have any questions about this form or process, please contact Aqua at 877.987.2782.