Water Lien Exemption Request

Recognizing that as a landlord, you have unique customer needs, Des Moines Water Works has provided you with an electronic form to assist you in better managing your properties and protecting your interests. Because of the protection it affords you, landlords are encouraged to complete the form for each property you own or manage. You may also request copies of the form be mailed to you by contacting Des Moines Water Works at (515) 283-8700.

Your request will be processed and a confirmation will be sent to you within 14 business days. If you have not received your confirmation letter within the 14 days, please contact cscollections@dmww.com to verify the form has been received. It is the owner's responsibility to verify the form is received for their tenant account.

Fields marked with an asterisk (*) are required.

Landlord Information

Landlord Name*

Landlord Address*

Landlord Address Line 2

Landlord City or Town

Landlord State or Province

Landlord Zip or Postal Code

Landlord Phone Number*

Landlord Email*

Service Information

Service Address*

Service City or Town*

Service State*

Service Zip Code*

Tenant Information

Tenant Name*

Second Tenant Name

Tenant Phone*

Date of Occupancy*

Lien Exemption

The undersigned represents that he or she is the landlord of the separately metered, residential, rental property identified above, and that such property is occupied or is about to be occupied by the tenant identified above. Furthermore, the undersigned represents that neither the owner nor the tenant represent a contract buyer (contract buyers do not qualify for lien exemption). The undersigned requests an exemption from the possibility of a lien for water, sewer, solid waste and storm water services to such property in accordance with section 384.84, Code of Iowa. DMWW must receive a new written notice within thirty business days of a change in occupancy and within thirty business days of a change in ownership.

Lein Exemption - Landlord*

Yes

Request For Notice To Owner

Pursuant to sections 384.84(2)(c) and 384.84(3)(c), Code of Iowa as amended, and Section 502.3.1.2 of the Des Moines Water Works Rules and Regulations, the undersigned hereby represents that he or she is the owner of record on the property identified above, and hereby requests that he or she is given notice to the mailing address indicated above of any delinquent utility charges.

Owner of Record*

Yes

Change of Account (Owner Responsible)

As the owner of the listed property below, the undersigned authorizes water service to be automatically put into his/her name upon the request for a final billing from the existing tenant. Owners will be notified by mail when this change takes place.

Owner Responsible*

Yes

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