Associate Information Update Form

Company

This field is for validation purposes and should be left unchanged.

Basic Utility Information

Utility Name(Required)

Utility Type

Name of individual filling out this form(Required)

First Last

Title of individual filling out this form(Required)

Email of individual filling out this form(Required)

Enter Email Confirm Email

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Is your shipping address differnt then your mailing address?

Yes, it is a different address

No, it is the same as the mailing address

Not sure

Shipping Address

Street Address Address Line 2 City State ZIP Code

Office Phone(Required)

Office Fax

Emergency Phone Number(Required)

Utility Email

Enter Email Confirm Email

Website

Must use this format: (https://webstie-name.com)

Facebook Page

Must use this format: (https://facebook-name.com)

TAUD Region

Tennessee Grand Division

Entity Fiscal Year Ends

Charter Type

General Manager Name(Required)

First Last

General Manager Email(Required)

Enter Email Confirm Email

General Manager Phone(Required)

Office Manager Name(Required)

First Last

Office Manager Email(Required)

Enter Email Confirm Email

Office Manager Phone(Required)

Office Hours Open Time:

Office Hours Close Time:

Office Hours Days Open:

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Employees: Fulltime

Employees: Part Time

Board Information

Board Meeting-Frequency:(Required)

Board Meeting-Frequency Other:

Board Meeting-Occurrence:(Required)

Board Meeting-Occurrence Other:

Board Meeting-Day of the Week:(Required)

Board Meeting-Day of the Week Other:

Commissioners:(Required)

Elected

Self-Appointed

Mayor Appoints

Other

Commissioner 1

Commissioner Name(Required)

First Last

Board Position(Required)

Commissioner Email(Required)

Enter Email Confirm Email

Term Served(Required)

Term Ends(Required)

Commissioner 2

Commissioner Name(Required)

First Last

Board Position(Required)

Commissioner Email(Required)

Enter Email Confirm Email

Term Served(Required)

Term Ends(Required)

Commissioner 3

Commissioner Name(Required)

First Last

Board Position(Required)

Commissioner Email(Required)

Enter Email Confirm Email

Term Served(Required)

Term Ends(Required)

Do you have additional Commissioners?

Yes

No

Commissioner 4

Commissioner Name

First Last

Board Position

Commissioner Email

Enter Email Confirm Email

Term Served(Required)

Term Ends(Required)

Commissioner 5

Commissioner Name

First Last

Board Position

Commissioner Email

Enter Email Confirm Email

Term Served(Required)

Term Ends(Required)

Commissioner 6

Commissioner Name

First Last

Board Position

Commissioner Email

Enter Email Confirm Email

Term Served(Required)

Term Ends(Required)

Utility Services

Select all the Serivices your Utility Provides(Required)

Water

Wastewater

Distribution

Collection

Gas

Energy

Operations Wastewater

Treatment Cost per 1,000 gallons

Wastewater: Retail cost per 1,000 gallon

Residential Sewer Bill at 5,000 gal

Commercial Sewer Bill at 5,000 gal

What is your Residential Wastewater Base Rate?

Residential Sewer Connections (RSC)

Commercial Sewer Connections (CSC)

Industrial Sewer Connections (ISC)

Government Sewer Connections (GSC)

Total Sewer Connections (TSC)

Miles of Sewer Lateral

NPDES/SOP(Required)

If multiple separate with commas.

Wastewater Design Capacity

Wastewater Treatment Grade(Required)

Wastewater Contact Name(Required)

First Last

Wastewater Contact Email(Required)

Enter Email Confirm Email

Wastewater Contact Phone(Required)

Wastewater Treatment Plant Address

Street Address Address Line 2 City State ZIP Code

Collection Grade:(Required)

Operations Gas

Cost of Gas Production per 1,000 CF (MCF)

Residential Gas Bill for 5,000 CF

Commercial Gas Bill for 5,000 CF

What is your Residential Gas Base Rate?

If you have one.

Residential Gas Connections (RGC)

Commercial Gas Connections (CGC)

Industrial Gas Connections (IGC)

Government Gas Connections (GGC)

Total Gas Connections (TGC)

Miles of Gas Line

Operations Energy

Cost of Energy Production per 100 Kilowatt Hours (kWh)

Residential Energy Bill for 500 kWh

Commercial Energy Bill for 500 kWh

Residential Energy Connections (REC)

Commercial Energy Connections (CEC)

Industrial Energy Connections (IEC)

Government Energy Connections (GEC)

Total Energy Connections (TEC)

Miles of Energy Line

TAUD Utility Update Form

Basic Utility Information

Board Information

Commissioner 1

Commissioner 2

Commissioner 3

Commissioner 4

Commissioner 5

Commissioner 6

Utility Services

Operations Water

Operations Wastewater

Operations Gas

Operations Energy

Additional Links

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