PRINCETON PUBLIC UTILITIES COMMISSION
THIRD PARTY PROGRAM
By participating in this voluntary Third Party Program, it allows the Princeton Public Utilities Customer to share
utility account information from the Princeton Public Utilities Commission.
The third party would be able to assist the customer in avoiding the hardship that would result from a
disconnection of utility services, but is NOT required to pay the bill(s). The third party will have the right to contact
the Utility and provide information or work out a payment arrangement with the Utility.
If you agree to name a third party, please complete the form below and return it to the Princeton Public Utilities
Commission.
Request for Third Party Notice
Customer Name: __________________________________________________________________
Address: _________________________________________________________________________
City: ______________________________________ State: ______________ Zip: ______________
Phone number: _______________________________
Princeton Public Utilities Commission has permission to share account information with the person named
below. I understand this agreement does not remove my personal obligation for payments.
Customer signature: _____________________________________________ Date: _____________
Name of Third Party to be Notified
Name: __________________________________________________________________________
Address: ________________________________________________________________________
City: _____________________________________ State: ______________ Zip: ______________
Phone number: _______________________________
Princeton Public Utilities Commission will make every effort to send a copy of any disconnect notice to the party
named above. The customer making this request understands we are not liable should the third party fail to
receive or act upon this notice.
A copy of the disconnect notice to a third party does not place any obligation on that party to pay bills for others,
nor will it prevent disconnection of electric or water service if payment is not made.
Please mail completed applications to:
Princeton Public Utilities Commission
P.O. Box 218
Princeton, MN 55371
763-389-2252