Cedar Hill, TX - Official Website

New Residential Utility Service Application

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Residential Applicant Information:

Service Address:*

Billing Address:*

Billing Zip Code*

Customer Name:*

Driver's License Number:*

Driver's License State (issued by):*

Social Security Number:*

Cell Phone Number:*

E-Mail Address:*

Desired Service Start Date:*

Spouse or Other Adult Occupant (Optional):

Spouse/Other Adult Occupant Name:

Spouse/Other Occupant Driver's License Number:

Spouse/Other Occupant Driver's License State (issued by):

Spouse/Other Occupant Social Security Number:

Spouse/Other Occupant Cell Phone Number:

Spouse/Other Occupant E-Mail Address:

I desire that my application information be kept confidential:*

Yes

* indicates required fields.