New Customer Service Form

2. 

4. Please use this form if you are a new customer, need to add a name or change you bill to address, or need to shut off service. If you would like print out this form and deliver in person, you may do so by clicking on the link below and dropping it off at our Main office at 6595 East 70th Ave, Commerce City, Co 80022.

   Please use this form if you are a new customer, need to add a name or change you bill to address, or need to shut off service. If you would like print out this form and deliver in person, you may do so by clicking on the link below and dropping it off at our Main office at 6595 East 70th Ave, Commerce City, Co 80022.

6. Printable New Customer Service Form

8. Application Request*

   1. New Service
   2. Add name or Bill to Address Change
   3. Shut off Request

10. Name of Applicant *

11. Phone Number*

13. Name of Second Applicant

    If needed

15. Service Address*

16. City*

18. State*

19. Zip*

21. Billing Address*

22. City*

24. State*

25. Zip*

27. Previous Address

    Required - If you lived in the District before

28. City

30. State

31. Zip

33. Do you want the water turned:*

    1. On
    2. Off

34. Effective Date*
    Effective Date

35. Are you the owner or renter?*

    1. Owner
    2. Renter

37. Click Here*

    1. I agree my electronic submission of this form constitutes my signature affirming the above information is true and correct.

39. Signature:*

40. Date*
    Date

42. Email Address*

44. Owner:

    If you are not the owner, please list owner's name:

45. Owner's Phone #

47. Owner's Address

48. City

50. State

51. Zip

Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field