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Utility Electronic Bill Sign Up

First Name*
Last Name*
Company Name
If applicable
Utility Account Number *
Email Address *
Block*
Lot*
Qual
Address*
Name on the Bill
*if different than requestor
Please Note:
Signing up for eBill will eliminate a paper bill to be mailed. To receive a postcard bill again, please submit in writing to remove the email for the e-billing.
Signature*
By signing (electronically), I accept the eBill will be in place of a paper bill.
Date*
Date
Date

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1. Receive an email copy of this form.
Email address

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Submit