Utility Service Transfer Request

Utility Service Transfer Request

This form is used to transfer utility services.

Do not report emergencies with this form!
Dial 9-1-1 for all emergencies!

 

* Denotes a required field
 

Customer Information

*
 
*
Social Security Number*
--
 
*
Daytime Telephone 
-- 
Evening Telephone 
-- 
Mobile Telephone 
-- 

Transferring Services

*
Would you like City Services (Water, Sewage & Garbage) at the new location?*
If yes, when would you like City Services at the new location? 
 
Would you like Natural Gas at the new location?*
If yes, when would you like your Natural Gas at the new location? 
 
*
 
*Your account number can be found on your bill. We MUST have this number to process this request.
Would you like your Water Services terminated at the old location?*
If yes, when would you like your water service terminated at the old location? 
 
Would you like your Natural Gas Services terminated at the old location?*
If yes, when would you like your Natural Gas services terminated at the old location? 
 

By electronically signing below in all caps, the customer agrees to be billed a $20.00 transfer charge and to be billed the necessary deposits, if there is no deposit already on account. Generally, there is a $150.00 water deposit required and a $150.00 gas deposit required (if applicable). Deposits for businesses will be more. 
Prior to the transfer, termination, or establishment of any City Services, City Hall must receive a photocopy of the Customer's Identification and rent receipt (if a renter establishing services). Please fax the Identification and information to (229) 246-7311 to the attention of the BILLING COORDINATOR. 
You must be present at the service location in order to have services connected. 
NEW TAPS: If the City's water works, sewer system, or gas system has not already been "tapped" there will be additional charges for these services.

*Please type in all capital letters to electronically sign.
*
Date*
 Date
 

 



Security Measure