Account Update Form

Account Update Form
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Customer
Name*

First NameLast Name
Account Number*
Date of Birth *

MonthDayYear
Date
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Government Identification*

Attach a copy of Government IDTake Picture of Government ID
Valid copy of Government Identification *

either State Driver's License, State Identification, Passport Book/Card, etc...
Cancelof
Take Photo of Government Identification*
Current Customer Signature*

Clear
Would you like to:*

Add another Account UserBe removed from the AccountUpdate Billing PreferenceUpdate Account Information (Applicant Name Change)
Name Change due to divorce: A copy of the divorce decree and updated drivers license must accompany this signed form.

Name Change if due to marriage: A copy of the marriage license and updated drivers license must accompany this signed form.

Name Change if due to death: A copy of the death certificate, and a copy of a will or legal documentation showing ownership of the estate must accompany this signed form. A copy of the drivers license for the new account holder is required.

Legal name change: A copy of the court document and updated drivers license must accompany this signed form.
Upload Legal Document indicating removal from utilities *

Example: Divorce Decree, Death Certificate, etc
Cancelof
Government Identification*

Attach a copy of Government IDTake Picture of Government ID
New Applicant to the Account *

First NameLast Name
New Applicant Date of Birth *

MonthDayYear
Date
New Applicant Phone Number*
Please enter a valid phone number.
New Applicant Government Identification*

Attach a copy of Government IDTake Picture of Government ID
Valid copy of Government Identification *

either State Driver's License, State Identification, Passport Book/Card, etc...
Cancelof
Take Photo of Government Identification*
Add Signer Terms & Conditions
Current Customer
I, as primary account holder for the utility account noted above (the “Account”), authorize the District to add a Secondary Account Holder to the Account. I agree that, as a result, the Secondary Account Holder will have all rights and privileges with respect to the Account, including, but not limited to, the ability to obtain information, receive security deposits, make changes to the Account, obtain certain confidential information, obtain information on and make payments to the Account, review usage amounts, complete a change of address, and authorize service requests and termination of service on the Account.
Current Customer Signature*

Clear
New Applicant
I agree to be bound by and comply with all of the terms and conditions applicable to the Account, including the District’s Rules and Regulations regarding utility services and the Customer Service Agreement executed by Primary Account Holder at the time that the Account was established. I understand and agree that, by being added to the Account, I will be responsible for all water and wastewater services provided to the property served by the Account until such time as the Account is terminated in accordance with the District’s Rules and Regulations, and I agree to pay for all utility services rendered to the property served by the Account in a timely manner. I understand that a violation of the terms and conditions of the Account may result in a penalty and/or termination of utility services to the property served by the Account. I further certify that the information above is true and correct.
New Applicant Signature*

Clear
Billing Preference*

PaperElectronic
Please detail what you would like updated on the account:*
Example: Change name from April Smith to April Doe due to marriage
Should be Empty:

Account Update Form

Current Customer

Add Signer Terms & Conditions

Current Customer

New Applicant