Utilities Application - Residential

Residential Application for Service

Required Documents

  1. Lease agreement from Landlord (must have renter’s name, address, and landlord’s signature) or proof of home ownership
  2. Photo ID
  3. Document with Social Security Number on it (examples: Social Security Card, bank statement, insurance card)

Applicant Information

Number of Persons Living in Household:

Local Friend or Relative Not Living at Your Address:

Authorized Person

Someone other than applicant who will have the authorization to receive information, change service and/or final bill account. It is not required to have an authorized person listed on your account.

Contact Information

The City of Thomasville uses an auto-notify system to provide courtesy payment reminders on your due date to help you avoid late fees and/or disconnection of service. If you do not wish to be notified, please leave the Auto-Notify # field blank.

Agreement

I certify that everything that I have stated on this application is true to the best of my knowledge. I authorize you to check my submitted paperwork and confirm employment. I understand that I must update credit information at your request if my financial condition changes. I agree to follow and abide by all rules for utilities services and to pay charges in effect as stated on each monthly bill. If I change service address or add an additional service address, I will be bound by this application. I understand that non-payment of my account will result in discontinuation of service.