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Name Change Authorization Letter

A customer authorized Hartselle Utilities to transfer their utility account into the name of a new account holder due to an unspecified reason. The letter states that any deposits on the existing account will be transferred to the new account holder, who must provide the letter, a driver's license, and social security number in person at Hartselle Utilities' office to complete the transfer and accept responsibility for any existing balance.

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Jay Arnel Flores
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2K views1 page

Name Change Authorization Letter

A customer authorized Hartselle Utilities to transfer their utility account into the name of a new account holder due to an unspecified reason. The letter states that any deposits on the existing account will be transferred to the new account holder, who must provide the letter, a driver's license, and social security number in person at Hartselle Utilities' office to complete the transfer and accept responsibility for any existing balance.

Uploaded by

Jay Arnel Flores
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Name Change Authorization Letter

Date:

I, , do hereby authorize Hartselle


Utilities to transfer account number for address
into the name of
due to . I authorize
any deposits on said account to be transferred to the above named individual.

To complete this transfer, the new account holder is required to provide this form, in
person, with his/her driver’s license and his/her social security number at Hartselle Utilities’ main
office located at 1010 Sparkman Street NW Hartselle, Alabama 35640. Further, the new account
holder understands that they will be responsible for any existing balance on the account number
listed in this document.

Existing Account Holder:


Signed: Date:
Telephone Number:
Last 4 digits of Social Security Number:

New Account Holder:


Signed: Date:
Telephone Number:

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