City of Commerce, Oklahoma

New Customer Service Application For Utility- Residential/Business

$150.00 Deposit for Service- Must have 2 forms of Identification $25.00 Non-Refundable Fee for Transfer of Services

Service Request Date*

First Name*

Middle Int.

Last Name*

Service Address*

Mailing Address (If Different)

Date of Birth*

Social Security Number*

Daytime Phone #

Cell Phone # *

Work Phone #

Employer

Employer Phone #

If Renting- Landlord's Name

List All Adults Living at Address*

Additional Responsible Person | First Name

Middle Int.

Last Name

Service Address

Mailing Address (If Different)

Date of Birth

Social Security Number

Daytime Phone #

Cell Phone #

Employer

Employer Phone #

The above responsible party/parties agrees to pay the established rates set by the City of Commerce and agrees to the regulation governing said service. This application becomes a contract upon the establishment of service. *

Only the account holders can make changes to the water account and must bring in picture I.D.*

I understand by agreeing below I am signing this contract that I am responsible for all charges on this account monthly, whether a bill is received or not.*