The City of Washington, Indiana

Small City... Big Possibilities

WMU Utilities Activation Form (Residential)

 Step 1 of 1

Form for residential utility hookup

* Denotes a required field

Residential Utilities Activation Form

 
 
 
 
Social Security Number 
--
 
Telephone Number 
-- ext
 
 
 
 
 
 
Spouse's SSN 
--
 
Spouse's Telephone Number 
-- ext
 
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
 
 
Zip Code 
-
Second portion of ZIP Code is optional.
 
 
 
Billing Address Zip Code 
-
Second portion of ZIP Code is optional.
 
 
Are you renting at this address? (If renting, you must attach copy of lease) 
 
 
 
Requested Date of Service Connection 
 Requested Date of Service Connection
Utilities Requested 
 
Washington Municipal Utilities has my permission to release information about my account to the following persons/agencies: (We cannot give information about your account to anyone without your permission. This includes family members, landlords, charitable agencies, etc.)
I have read through the above information and duly attest that the above responses are true. I understand that misrepresentation or omission of any facts or information called for on this application is subject to any and all City of Washington codes and/or ordinances. I understand that if such information is found to be false (fraudulent), the City of Washington will be bound to resolve this matter in accordance to its policies, codes, and/or ordinances, which may include any necessary fees or fines.
*