The City of Washington, Indiana

Small City... Big Possibilities

WMU Utilities Activation Form (Commercial)

 Step 1 of 1

This is the commercial utilities request form

* Denotes a required field

Commercial Utilities Activation Form

 
 
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
 
 
Zip Code 
-
Second portion of ZIP Code is optional.
 
Tax Exempt (If yes, form required) 
Telephone Number 
-- ext
Fax Number 
-- ext

Business Owner Information

 
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
 
 
 
Zip Code 
-
Second portion of ZIP Code is optional.
 
 
 
 
Telephone Number 
-- ext

Billing Name and Address (If different from service address)

 
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
 
 
Zip Code 
-
Second portion of ZIP Code is optional.
 
Utilities Requested 
 
 
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.
*