Application For New Service

Subject to the rules and bylaws of The Putnam Community Water Corporation on file in this office, which the applicant agrees shall be part of this contract, application for the water by meter at the address shown below and in consideration of the delivery of water to the applicant by said department applicant agrees to:

Pay for all water delivered to the service address at the published rates of the water department and to settle all bills therefore, bi-monthly, within the specified time via approved payment options.
A deposit of $100.00 for owner or $150.00 for tenant is required to establish service. This deposit will appear on your first statement, and is due upon receipt.
Pay service charge for financial institution charge back.

Select Which Applies(Required)

Home Owner

Tenant

Name(Required)

First Last

Water Service Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Billing Address (If Different From Service Address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Main Phone Number(Required)

Secondary Phone

Email(Required)

Previous Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Place of Employment(Required)

Property Owner (If Tenant)

Property Owner Address (If Tenant)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Today's Date(Required)

Signature(Required)

Application For New Service

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