Utility Release Form
For evaluation purposes only, Enterprise will contact your local utility company directly to verify
and/or obtain energy and water consumption data to track the cost-effectiveness of green building
practices in reducing resource consumption.
By signing this release form, I, Authorized Property Owner Representative/Customer Name,
grant Enterprise Community Partners, Inc. permission to access and assess past, current, and 60month future energy/water billing and consumption information for ongoing tracking of energy and
water usage.
Residential Usage: In connection to this release, property owner/developer agrees to collect utility
release forms from 15% of residents to track actual utility data of a sample of homes.
Property Name:
Organization Name:
Contact Name:
Contact Title:
Contact Phone:
Contact Email Address:
Address:
City:
State
Zip:
Utility Information
Electricity Utility:
Account Name:
Address:
Account Number:
City:
State:
Zip:
Natural Gas Utility:
Account Name:
Address:
Account Number:
City:
State:
Zip:
Water Service Provider:
Account Name:
Address:
Account Number:
City:
State:
Zip:
I certify that I have read this Utility Release Form and agree to the terms set forth above:
Signature:
Date Signed:
The information obtained pursuant to the release shall be treated as confidential to the
maximum extent permitted by law.