Application for Service

Application for Service
Please complete the form below to apply for service. Click the "Browse Files" buttons to select the following required documentation.
Proof of occupancy:

A signed lease, deed, or another for of proof of ownership, such as a tax record, sales contract or settlement statement.

Identification:

A copy of a government issued photo ID such as a driver's license, state ID or passport.

*Fields with astericks are required.
Name

First NameLast Name
Organization Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Place of Employment
12-digit Account Number
Service Address

Street Address

Street Address Line 2

CityState

Zip Code
Is your mailling address the same as the service address?
Mailing Address

Street Address

Street Address Line 2

CityState

Zip Code
Connection Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Do you own or lease?
SSN or EIN
Government Issued ID

Cancelof
Front Page of Lease/Purchase Agreement

Cancelof
Signature Page of Lease/Purchase Agreement

Cancelof
I understand that all information provided on this application will be maintained by Central Alabama Water and shared with the appropriate municipality for the purposes of establishing a sewer service account, if applicable, and for the administration thereof. I understand that in the event the Utility places the account with a third-party debt collection agency for failure to make payments as agreed, additional charges may be imposed, including but not limited to collection fees, attorneys’ fees, legal costs, expenses, and transactional fees (for use of certain payment methods). I understand that by providing the Utility(ies) with my telephone number, I give consent for the Utility(ies), and/or their respective agents (including their collection agents), to contact me at the telephone numbers provided or any other phone number that is later acquired, and to leave live or pre-recorded messages or text messages to the extent that such efforts are necessary to service my account or enforce any part of my service agreement. Additionally, I consent that calls may be delivered by an auto-dialer. I also understand that by providing an email address, I give my consent to receive emails from the Utility(ies), or any of their respective agents (including the Utility(ies’) collection agents), that may contain billing or other account information.
I have read and understand the above information.
Review Central Alabama Water's Privacy Statement.
I have read the Privacy Statement.
Please verify that you are human
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