Account Information:

 *

Account Information:

Service address

Current Name on Account

Last 4 digits of SSN for Current Name on Account:

Current Co-Applicant Name on Account (if applicable)

Last 4 digits of SSN for Current Co-Applicant Name on Account

Reason For Update: (select ALL that apply)

 *

Reason For Update: (select ALL that apply)

New Phone Number

Mailing Address (for billing purposes ONLY, this does NOT close the account)

Legal Name Change due to marriage/divorce/legal change

Name Change due to deceased primary and surviving current owner

Change to:

Change to:

ext.New Phone Number

New Mailing Address

New Legal Name due to marriage/divorce/legal change (legal documents must be submitted)

Name Change due to deceased primary and surviving current owner (death certificate must be submitted)

Legal forms can be emailed to waterbilling@avondaleaz.gov or uploaded below.

Legal forms can be emailed to waterbilling@avondaleaz.gov or uploaded below. Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

Information of person requesting the update:

 *

Information of person requesting the update:

Name:	Phone #ext.
Last 4 digits of SSN#:	State Driver's License or Identification #
Email Address

Typing my name in the box below serves as my "electronic signature" and authorizes the City of Avondale to update my utility account.
Electronic Signature:

 *

Typing my name in the box below serves as my "electronic signature" and authorizes the City of Avondale to update my utility account. Electronic Signature:

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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