Request for Final Utility Billing

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Angela Hornberg
Clerk/Treasurer
ahornberg@holmenwi.gov
Ann Quamme
Utility Clerk/Deputy Treasurer
aquamme@holmenwi.gov
Stephanie Mahr
Deputy Clerk/Deputy Treasurer
smahr@holmenwi.gov
Kelly Goyette
Deputy Clerk/Deputy Treasurer
kgoyette@holmenwi.gov
Rhonda Hesselberg
Administrative Assistant/Receptionist
rhesselberg@holmenwi.gov
(608) 526-4336
Fax: (608) 526-4357
421 S. Main St.
P.O. Box 158
Holmen, WI 54636
Office Hours:
Monday – Friday
8:00 AM to 4:30 PM

IMPORTANT: AFTER SUBMITTING THIS REQUEST, YOU WILL RECEIVE AN E-MAIL CONFIRMATION FROM THE UTILITY. SHOULD YOU NOT RECEIVE THE CONFIRMATION E-MAIL WITHIN ONE BUSINESS DAY, PLEASE CONTACT THE VILLAGE OFFICE AT (608) 526-4336 TO ENSURE THEY HAVE RECEIVED YOUR REQUEST.

"*" indicates required fields

Requested by*

First Last

Daytime Phone*

Email*

Service Address*

Street Address Address Line 2 City State ZIP Code

Parcel Number*

Date you want meter read for final bill reading*

Closing Date*

Seller's Information

Seller's Name*

First Last

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Buyer's Information

Buyer's Name*

First Last

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Final Bill Delivery Information

I would like my final bill to be*

Emailed

Faxed

Mailed

Company Name*

Attention*

Recipient Email*

Recipient Fax*

Recipient Name*

First Last

Recipient Address*

Street Address Address Line 2 City State ZIP Code

Recipient Phone