Utility User Tax (UUT) Contact & Payment Information Form

Purpose:

This form collects essential contact and payment information from utility providers operating in Isla Vista. It ensures the District can verify tax remittances, reconcile payments to specific service addresses, and clarify reporting periods.

If you have any questions please email assistantgm@islavistacsd.com or call 805-770-2752 ext. 1

Utility Provider Information

Company Name

Mailing Address

Company Website

Primary Contact for UUT Remittance

Name

Title/Department

Phone Number

Billing & Payment Details

Payment Method

Check

ACH

Reporting Frequency (Monthly, Quarterly, Annually) If payments are delayed or retroactive, please indicate the reporting year/period on the remittance.

Remittance Details

Locations/Accounts in Isla Vista subject to UUT (Please attach a summary if known)

Tax Rate Used for Calculation (If different from the rate set by IVCSD, please explain)

Supporting Documents (Please attach the following if available)

Most recent tax remittance statement

Customer billing summaries by service address

Contact information for billing department (if different from above)

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