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The Highland Ditch Company |
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HIGHLAND DITCH COMPANY 4309 STATE HWY 66 LONGMONT, CO 80504 Tenant Information needs to be received prior to running ANY water!
STOCKHOLDER(S) INFORMATION Account No. ____________ NAME:_________________________________________________________________ ADDRESS:______________________________________________________________ CITY: ________________________ STATE: _________________ ZIP______________ PHONE NUMBERS: DAY: ______________________________________________ NIGHT: _____________________________________________ TENANT(S) INFORMATION Below list person(s) who you are authorizing, as the shareholder, to order water from your account for 2008. NAME: __________________________________ PHONE NO. ___________________ NAME: __________________________________ PHONE NO. ___________________ Are the above tenant(s) allowed to move water in and out of your account and or the Highland System? _____ YES _____ NO *_________________________________________ DATE: _______________________ Shareholder(s) Signature / if Entity state your position
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