City of Woodstock Water Connection Form

City of Woodstock Water Department

Phone: (770) 592-6006 E-mail: h2o@woodstockga.gov
*NEW SERVICE APPLICATIONS REQUIRE 24 HOUR NOTICE*

DEPOSIT INFORMATION

DEPOSITS ARE REQUIRED FOR EACH ACCOUNT AND ARE REFUNDED WHEN THE ACCOUNT IS CLOSED.

A CUSTOMER SERVICE REPRESENTATIVE WILL CONTACT YOU ON YOUR SELECTED FIRST DAY OF SERVICE TO COLLECT THE DEPOSIT.

OWNER/LANDLORD: $100.00

RENTER/LESSEE: $125.00

COMMERCIAL PROPERTY: $250.00
SERVICE ADDRESS:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
CONNECT MY WATER SERVICE ON: (MONDAY-FRIDAY ONLY)*

MonthDayYear
Click calendar icon to choose
Gas South Partnership

As a City of Woodstock customer, you get exclusive benefits for natural gas service when you sign up with Gas South. See details here: https://www.woodstockga.gov/services/gas_south.php
Please do not remit my contact information to Gas South
CUSTOMER INFORMATION
CUSTOMER TYPE:*
APPLICANT NAME:*

First NameLast Name
BUSINESS NAME (IF APPLICABLE)
IF MAILING ADDRESS DIFFERS FROM SERVICE ADDRESS, PLEASE PROVIDE ALTERNATE MAILING ADDRESS:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PRIMARY CONTACT PHONE: (REQUIRED)*

Area CodePhone Number
SECONDARY CONTACT PHONE:

Area CodePhone Number
E-MAIL ADDRESS: (REQUIRED)*
example@example.com
HOW WOULD YOU LIKE TO RECEIVE YOUR STATEMENT?*
***If renting, please provide owner's name and phone number below.
OWNER'S NAME

First NameLast Name
OWNER'S PHONE NUMBER:

Area CodePhone Number
ALTERNATE CONTACT INFORMATION
SPOUSE or ALTERNATE CONTACT PERSON: (IF APPLICABLE)

First NameLast Name
SPOUSE or ALTERNATE CONTACT PHONE: (IF APPLICABLE)

Area CodePhone Number
RELATIONSHIP TO APPLICANT?
Additional Information Needed

Please upload the following information below:

ALL RESIDENTIAL CUSTOMERS MUST UPLOAD A COPY OF THE DRIVER'S LICENSE (FRONT ONLY) BELOW.

***Renters: In addition to a driver's license, please also upload a copy of the first page and signature page of the lease agreement.

***Commercial/Mgmt Company: Please only upload a copy of the company's W-9.
Browse Files

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APPLICANT SIGNATURE: (USING MOUSE)

Clear
** A CUSTOMER SERVICE REPRESENTATIVE WILL CALL YOU ON THE FIRST DAY OF SERVICE TO COLLECT YOUR DEPOSIT **

Fees
- DEBIT: $2.95
- CREDIT: $2.95
If you do not wish to pay the debit/credit card fees, you may stop by our office to pay the deposit with a check, cash, or money order with no added charge. You can also mail the deposit check to:

City of Woodstock Water Department

12453 Highway 92

Woodstock, GA 30188

Please make all checks payable to City of Woodstock and please write the service address or account number in the memo line of the check.
Should be Empty:

City of Woodstock Water Department

Gas South Partnership

CUSTOMER INFORMATION

***If renting, please provide owner's name and phone number below.

ALTERNATE CONTACT INFORMATION