E-Gov Services Midland

Transfer Water Account From One Party to Second Party

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Use this form to request transfer of water service from one party to another. By completing this form the current account will be terminated, a new account in the second party's name will be created and water service will not be interrupted.

* Information is required.

Contact Information

* First Name:
* Last Name:
Business Name:
* Email:
* Daytime Phone:	() –
Address:
City:
State:
ZIP:

* Enter the service address

* Enter the current name on the water account for the above address (outgoing customer)

* Enter the outgoing customer's forwarding address for final billing

* Enter first, middle initial and last name of the new customer whose name is to be on the account. Note: Only one name may be on a water account.

* Is the new customer a person or a company?

person

company

* Occupant's status:
Note: Water accounts in tenant's name require a $35.00 deposit which will be subtracted from their final water bill.

Property manager is sending deposit

Yes

* Number of new occupants

* Phone number of new customer and type of phone (cell, home, business)

* New billing address, if different from service address

* What date does the new account need to be created?
Note: This date must be a business day and must be at least 2 working days from the date of form submission for the request to be processed.

* What time is best for you to have the service technician stop at your home?
Note: An adult must be present when the technician stops at the home. An actual read is required to transfer accounts from one customer to another.

Check here to have email confirmation of this request sent.

* Information is required.

Notes:

When you submit information through this form, you will receive a Tracking Number. You can track the status of your request by entering your tracking number in the field provided on the "Services and Information Requests" page.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.