Decatur New User Agreement Forms
Name
*
Name
First
First
Last
Last
Applicant
*
Owner
Builder
Landlord
Tenant
Business
Type Of Account
*
Residential
Irrigation
Agricultural
Commercial
Lot Assessment
Fire Hydrant
Date To Start Service
*
Date of Birth
*
SSN
Drivers License
Upload Drivers License
Choose File
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
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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.
Submit
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