Application for Service

Please complete all fields and bring this form to our office, or download the PDF version to print and fill by hand.

In order for us to turn your Water or Gas on, you must be at the service address when we come out.

When returning the form by email or fax (731) 772-8811, please include a copy of your lease agreement or closing papers, state-issued photo ID, and Social Security card.
Date & Account
Type of Service
Customer Information

If you are inside Stanton city limits you must provide a P.O. Box number.

Customer Identification & Contact
Spouse's Information
Deposit
Agreement

Applicant Signature

Spouse Signature

B.E.A. (CSR)