2. Account Number *
4. Address*
6. Name*
8. Phone Number*
9. Email*
11. Acknowledgement: I wish to enroll in E-Bill and receive my monthly water bill via email. I understand that I will no longer receive a paper copy of my monthly water bill.*

    1. Yes
    2. No
Leave This Blank:


13. 1. Receive an email copy of this form.
14. Email address

    This field is not part of the form submission.

15. Submit

* indicates a required field