Decatur Water Agreement – Sign Secure

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Decatur Water Agreement – Sign Secure

Decatur New User Agreement Forms

Name

Name

First

First

Last

Last

Applicant

Type Of Account

Date To Start Service

Date of Birth

SSN

Drivers License

Maximum file size: 15MB

Phone

Email

Service Address

Service City

Service Zip

Billing Address (If Different)

Billing Address (If Different)

Billing Address (If Different)

Billing Address (If Different)

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Paperless Billing

Yes

No

If you select yes you will not receive a paper bill.

Add Secondary Person to the Account

Yes

No

Name

Name

First

First

Last

Last

Date of Birth

Phone

Last 4 of SSN

Email

reCAPTCHA

Trash Service (Trash Service is required if in the City Limits)

Trash Service 12.75

If you are human, leave this field blank.