Application for Residential Service

Application for Residential Utility Service
Application Requirements: One form of identification and property lease agreement or proof of ownership.

We are unable to process your application without these documents.
Government Identification

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Please attach one form of state or government-issued picture identification. Cancel of
Co-Applicant Government Identification

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Please attach one form of state or government-issued picture identification for the co-applicant if adding one. Cancel of
Lease or Proof of Ownership of the Dwelling

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Please attach a copy or image of your lease, deed, proof of ownership or authorization form. Cancel of
Certificate of Occupancy

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Please attached a copy or image of your CO from the City of Greenville. Cancel of
Date *

Month Day Year
Date

Co-Applicant Information
Co-Applicant Name

First Name Last Name
Drivers License or ID #
State
Date of Birth

Month Day Year
Date

Additional Account Options
RoundUP

GEUS' RoundUP Program is easy to participate in and has the ability to make a huge impact on someone else in our community. Monthly, your GEUS bill will round up to the next dollar, those pennies go to people in our community for utility bill assistance.

How it works:

Each month your bill will be rounded up to the next dollar and that money will be used to help someone in our community with utility bill assistance.

So, if your bill is $185.43, the bill would be rounded up to $186.00 and the $0.57 would go to help a local family.

The average customer would only donate about $6.00 a year, and the maximum amount a customer could contribute annually would be $11.88.

Each donation is a very small amount from each GEUS customer, but the impact we can all make together will be significant to our community.
I hereby request to be included in GEUS' RoundUP Program. I understand that my monthly bill will be rounded to the nearest dollar. *

Yes No
Life Support
Is anyone in the home on a life support system? Please notify GEUS immediately if this changes.

Yes No
GEUS Late Charge Waiver Program
You may apply for the GEUS Late Charge Waiver program if your income is received only once per month and the bill due date does not fall within the range of your income. Would you like additional information on this program?

Yes No
I acknowledge that the above information has been explained to me, and understand the options I have chosen will be applied to my account and any forms to be filled out must be returned within 10 days of the date of connection. Failure to supply these forms could result in disconnection of service and disconnection fees may apply.
Applicant Signature *

First Name Last Name
Date *

Month Day Year
Date
Applicant E-Signature

Clear

Payment Options
GEUS offers multiple payment options.

Choose to pay your bill using the GEUS App, Online Bill Pay, Pay-By-Phone or Pay in Person options.

Visit our website to learn more about these easy to use payment options.

GEUS Payment Options

ID and Document Requirements
Document Requirements

If you did not attach the required documents in step 1 of the application process, you are required to provide those before services can be connected.

Services will not be connected until this information has been submitted.

How to submit these requirements:
Email CustomerService@geus.org or Call 903-457-2800.

I understand that I am required to submit the required documents explained in step 1 by contacting GEUS before my services will be connected.
Applicant Signature *

First Name Last Name
Date

Month Day Year
Date
Applicant E-Signature

Clear

Agreement
The Applicant, whose signature appears below, applies to GEUS for some or all of the following services: Electric, Water, Sewer, Garbage, Cable TV, Internet and other services incident thereto, to be supplied at the address herein described, and upon request, at any other local address to which Applicant may move. The Applicant agrees to pay for said services as bills are rendered therefore, in accordance with the rates, rules and regulations as provided in the City Charter or by City Ordinances as now existing or as may be enacted and in effect at the time of delivery, regardless of who the consumer might be. The Applicant further agrees to release and discharge said GEUS or the City of Greenville from a liability for damages suffered (1) by reason of electric or water currently furnished to the premises, or (2) by reason of interruption, discontinuance or disconnection of service hereunder from any cause other than negligence by GEUS or the City of Greenville or (3) by reason of the condition, maintenance, location, or existence of any of the facilities, fixtures or systems located on or adjoining the property supplied and by which services are furnished and delivered. Service requests for disconnections will be processed within 2 business days.

Applicant agrees to follow all current or as amended policies and procedures established in the Greenville City Ordinances and GEUS Service Policy. Such policies and procedures can be found on the links provided.

Greenville City Ordinances

GEUS Service Policy (PDF)

My signature is an acknowledgement that this is a contract and that I personally agree to make payments and am guaranteeing payment of all sums due and owing on behalf of myself and anyone using services at this address. Additionally, by submitting this form via electronically, I agree to conduct business electronically and an electronic signature is binding on me. If I move from this address, it is my responsibility to contact GEUS to terminate this account. I will remain responsible for the amounts owed on or services charged to this account until such time as I terminate this account.
Applicant Signature *

First Name Last Name
Date *

Month Day Year
Date
Applicant E-Signature

Clear
Co- Applicant Signature

First Name Last Name
Date

Month Day Year
Date
An email with your completed application will automatically be sent to the email address you provided.
Should be Empty:

Application for Residential Utility Service

Applicant Information

Co-Applicant Information

Requested Utilites

Information Releasable to:

Recycling Service Options

RoundUP

Life Support

Internet & Cable

Payment Options

ID and Document Requirements

Agreement