Service Request

Service Account Number

Date

04/20/24

Reason

Schedule Date

First Name

Customer Name

Contact Phone Number

Alternate Number

Schedule Time

Pets

Locked Gates

Enter your information

Please enter contact information for the person(s) responsible for the account

First Name

Customer Name(s)

Contact Phone Number

Email Address

SSN

Alternate Number

Where are you moving from

Please enter the address where you would like to stop service

Requested Stop Date

Apt/Unit Number/Suite

State

Service Location

City

Zip Code

Where are you moving to?

Please enter the address where you would like to start service

Requested Start/Possession Date

Apt/Unit Number/Suite

State

Service Location

City

Zip Code

Mailing information

Please enter the address where you would like your bill sent.

Same as Service Location Address

Mailing Address Street

City

Zip Code

Apt/Unit Number/Suite

State

Security Deposit and Setup Fee

MySPWater™ will assess a non-refundable $15 connect fee for all newly activated electric accounts. Additionally based on your credit you are required to provide a security deposit of $250 for this new account. Please select payment options below to pay the connect fee and security deposit

Payment Method

Credit Card

Bank Account

Card Number

Month

Amount No.

(in $)

Security code

Year

Account Holder Name

Bank Name

Routing Number

Bank Account Number

Own or Rent

Do you own or rent this home?

Own Rent

If you rent this home please provide owner or Property Management Company information below

Name

Mailing Address

Apt/Unit Number/Suite

State

Is this address served by [UTILITYNAME]?*

Yes,current address is served by [UTILITYNAME]

No,address is NOT served by [UTILITYNAME]

Phone Number

Email Address

City

Zip Code

Where are you moving to?

Apt/Unit Number/Suite

State

When are you moving in?

(Request will be processed the next business day)

Street Name

City

Zip Code

Contact Information

Contact Phone Number

Email Address

Alternate Number

Mailing Address

Same as moving address

Apt/Unit Number/Suite

State

Street Name

City

Zip Code

Enter your information

Please enter contact information for the person(s) responsible for the account

Customer Name(s)

Contact Phone Number

New Owner or Tenant's Name

Email Address

Alternate Number

Where are you moving from

Please enter the address where you would like to stop service

Requested Stop Date

Apt/Unit Number/Suite

State

Service Location

City

Zip Code

Forwarding Address Mailing information

Please enter the address where you would like your final bill sent

Mailing Address Street

City

Zip Code

Do you own or rent this home?

Own Rent

Apt/Unit Number/Suite

State

Forwarding Address Mailing information

When are you moving out?

Where are you moving to?

Street Number

Street Name

City

Zip Code

Mod

Apt/Unit Number/Suite

State

When are you moving in?

(The Request will be processed the next business day)

Contact Information

Contact Phone Number

Email Address

Alternate Number

Mailing Address

Same as moving address

Street Number

Street Name

City

Mod

Apt/Unit Number/Suite

State

Zip Code

Please Verify

Add Attachment

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Additional Comments

Use this form to contact MySPWater™ to make a service request such as move in, move out, transfer service, etc

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