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Utility Services Form
Leave This Blank:
This form may be used by residential or commercial customers to begin, stop or transfer utility services. It may be submitted online with the personal identifying information to be completed by phone at 361-758-5301 or in person at City Hall.
Mark the one which applies for this application.
*
Residential
Commercial
Mark the button which applies to this application
*
Begin Service
Stop Service
Date To Turn On/Off Service:
*
Applicant Name:
*
Service Address:
*
Utility Account Number
Check the box which applies.
*
Property Owner
Rental Property
If rental property, complete the following:
Landlord's Name
Landlord's Phone Number
Applicant's Mailing Address:
*
City, State, Zip
*
Phone Number:
*
Email Address:
*
* **Additional Address for Service Transfer and/or Forwarding
Address
City, State, Zip
THE FOLLOWING PERSONAL IDENTIFICATION INFORMATION MUST BE COMPLETED IN PERSON OR BY PHONE. TO PROTECT THIS INFORMATION, DO NOT COMPLETE ONLINE.
Social Security Number
Driver License Number
THE FOLLOWING INFORMATION WILL BE COMPLETED BY UTILITY CLERK FOLLOWING COMPLETION OF APPLICATION.
Meter Number
MXU Number
Deposit Date or Deposit Return Date
Deposit or Refund Amount
* indicates required fields.
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