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Utility Service Application
Utility Service Application
Applicant Information
Check here if you are currently a customer of Carrollton Utilities at another address:
Current Account:
*
Create Cut-off Service Order for Current Account?
Requested Turn Off Date:
*
Requested Turn Off Time:
*
×
Social Security Number
Enter last 4 digits of SSN:
*
Please indicate type of account:
Residential:
Business:
Business Name:
*
First Name:
*
Middle Name:
Last Name:
*
Date of Birth:
*
Home Phone:
*
Mobile Phone:
*
Federal ID:
*
Work Phone:
*
Email:
*
Driver's License:
*
SSN:
*
Gender:
Ethnicity:
Race:
Name:
Home Phone:
Mobile Phone:
Work Phone:
Email:
*
Date of Birth:
*
Driver's License:
SSN:
Relationship:
Remove Co-Applicant
Please enter the address for which you are requesting service.
Address:
*
City:
*
State:
*
Zip Code:
*
Check if you own this residence:
Name of mortgage company: Name of landlord:
Check if your billing address is same as the service address:
If not, please enter your billing address
Address:
*
State:
*
City:
*
Zip Code:
*
Address:
City:
State:
Zip Code:
Requested Turn on Date for Utilities:
*
Requested Turn on Time for Utilities:
*
Name:
*
Phone No:
*
Address:
City:
State:
Zip Code:
Additional Comments:
Please attach required documents here:
Drag file here
Current Image:
Check here if you are currently a customer of Carrollton Utilities at another address:
Current Account:
Create Cut-off Service Order for Current Account
Requested Turn Off Date:
Requested Turn Off Time:
Type of account:
First Name:
Middle Name:
Last Name:
Business Name:
Date of Birth:
Home Phone:
Mobile Phone:
Work Phone:
Email:
Driver's License:
SSN:
Federal ID:
Co-Applicant Information:
Name:
Home Phone:
Mobile Phone:
Work Phone:
Email:
Date of Birth:
Driver's License:
SSN:
Relationship:
Service Address:
Address:
State:
City:
Zip Code:
Check if you own this residence:
Name of mortgage company: Name of landlord:
Check if your billing address is same as the service address:
If not, please enter your billing address
Address:
State:
City:
Zip Code:
Previous Address:
Address:
State:
City:
Zip Code:
Requested Turn on Date for Utilities:
Requested Turn on Time for Utilities:
Name:
Address:
State:
Phone No:
City:
Zip Code:
Additional Comments:
New service applications are processed from 8am until 3pm EST. Applications for new service received after 3pm EST will be processed the following business day. If all required documentation is not provided, there may be delays in processing your application or you may be required to come to the office. Service will not begin until deposit/all fees are paid. All services can only be turned on by qualified Carrollton Utilities staff. It is the customer's responsibility to ensure that all water faucets are off and there are no leaks during the turn on procedure. Should your leak indicator be turning, your water will be turned back off and the meter locked. Never want to miss bill? Sign up for our new e-billing service! It is fast, easy and secure. Know the minute your billing statement is ready. View and pay bills anytime. Contact our office for more info.
Initials:
Your application has been submitted. You will receive a notification whether it has been denied or approved once it has been processed and completed.
Your application number is
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