Water Account Application

Applicant Name on Account*
First Last
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Physical Address*
Same as Mailing Address

Street Address Address Line 2 City State ZIP Code
SSN #/ EIN #*
Drivers License #*
State of Drivers License*
Telephone Number*
Work
Cell*
E-mail Address*
E-mail Bill: Your bill will be sent to your email ONLY.*
- YES EMAIL
- NO
Effective date of service
MM slash DD slash YYYY
Check all that apply
- Residential Unit
- Commercial Unit
- Hills Quarters (Out of Town)
Dwelling Type
If renting a home or commercial location in the town of Kilmarnock, a meter deposit will be required. The deposit MUST be paid before the account can be set up.

Deposit Due:
Residential - $150.00
Commercial - $300.00
Hills Quarters - $225.00
If water is currently OFF, there is a Turn On Fee of $25.00 for in-Town accounts and $37.50 for out-of-Town locations.
- Water On
- Water Off
Sign Here*
First Last
*
I agree to electronically sign and to create a legally binding document between the other party and myself, or the entity I am authorized to represent.*