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Service

ERROR

Service Account Number

Reason

Date

07/19/18

Schedule Date

Schedule Time

First Name

Middle Name

Last Name

Pets

Mobile Number

Locked Gates

Alternate Number

Current Service Address

Street Number

Street Name

Apt/Unit Number

City

State

Zip Code

Start Service | Home

Enter your information

Please enter contact information for the person responsible for the account

Customer Name

Date of Birth

Mobile Number

Mobile Number

Alternate Number

Mobile Number

Email

Will any other adults be living at the new service address?

Customer Name

Date of Birth

Relationship

Current Address

Please enter your current address

Street Number

Street Name

Type

Apt/Unit Number

City

State

Zip Code

Where are you moving to?

Please enter the address where you'd like to start service.

Requested Start Date

(Requests will be processed the next business day)

Street Number

Street Name

Type

Apt/Unit Number

City

State

Zip Code

Do you own or rent this home?

Own Rent

Mailing Address

Same as New Address

Please enter the address where you'd like your bill sent.

Street Address P.O. Box

Street Number

Street Name

Type

Apt/Unit Number

P.O. Box

City

State

Zip Code

Please Verify

Where are you moving to?

Street Name

Apt/Unit Number

City

State

Zip Code

When are you moving in?

(Request will be processed the next business day)
Contact Information

Mobile Number

Alternate Number

Email

Mailing Address
Same as moving address

Street Name

Apt/Unit Number

City

State

Zip Code

When?

When are you moving out?

(Requests will be processed the next business day)
Contact Information

Mobile Number

Alternate Number

Email

Mailing Address

Street Number

Street Name

Apt/Unit Number

City

State

Zip Code

When?

When are you moving out?

(Requests will be processed the next business day)
Where are you moving to?

Street Number

Street Name

Apt/Unit Number

City

State

Zip Code

When are you moving in?

(The Request will be processed the next business day)
Contact Information

Mobile Number

Alternate Number

Email

Mailing Address
Same as moving address

Street Number

Street Name

Apt/Unit Number

City

State

Zip Code


Add Attachment

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Additional Comments

Use this form to contact Evansville Water and Sewer Utility to make a service request, such as move in, move out, transfer service, etc

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