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Utility Account Changes

2. City of Decatur
   Utility Account Changes

   Utility Account Changes

4. Date*
   Date

5. Requested Change*
   -- Select One --Disconnect ServiceTransfer of ServiceChange of Legal Name

7. Current Name on Account*

8. Current Service Address*

10. Phone Number

11. Email Address

15. To Final/Disconnect Service

17. Enter forwarding address

18. Date to Disconnect
    Date to Disconnect

22. To Transfer Service

24. Date to disconnect current at current service address
    Date to disconnect current at current service address

25. Date to connect at new service address
    Date to connect at new service address

27. New Service Address

28. Copy of Lease Agreement/Proof of Ownership

    A copy of your lease agreement or proof of ownership is REQUIRED and may be uploaded here, emailed to utilities@decaturtx.org, or submitted in person. We must receive a copy of your lease agreement or proof of ownership BEFORE deposit is paid and service is started.

30. ***For transfers only, the City of Decatur will bill a $10.00 non-refundable transfer fee.

34. To Update Legal Name or Mailing Address

36. Updated Legal Name

37. Document(s) reflecting legal name change

41. CONFIDENTIALITY REQUEST

    1. I hereby request confidentiality of my personal information by the City of Decatur’s Utility Billing Division.

43. **All Delinquent Accounts will be sent to McCreary, Veselka, Bragg & Allen, P. C. Attorneys at Law

45. Signature
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

47. I agree to the above statement and confirm that all the information on this application is true and accurate to the best of my knowledge.*

    1. I AGREE

49. Signature: First M. Last*

Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field