Cumming Utilities

Residential Service Application


RESIDENTIAL APPLICATION FOR SERVICE

Use the form below to apply for water and sewer service for Residential Accounts. For Commerical Customers use our Commercial Application Form

Security Deposit

A $125.00 deposit is required at the time of this application to establish service. This deposit will not bear interest and will be deposited into the general fund account of the City of Cumming.

If you plan to move from this location or wish to terminate your service, it is YOUR RESPONSIBILITY to notify the City of Cumming Department of Utilities of the day that you wish to terminate service via the City’s Service Termination Form. Your service will be terminated and your meter will be read on that day.

A final bill will be generated and sent to you during the next billing cycle. The $125.00 deposit will be applied to the final bill. Please provide the Department of Utilities with a forwarding address so that the final bill and/or refund will be mailed to the proper person.

If you are moving to another residence within the City’s service area and currently have a $50.00 deposit on file with the City, you will be required to pay an additional $75.00 to transfer service to the new residence. Your previous deposit of $50.00 will be added to the $75.00 and your account will then reflect a $125.00 deposit.

Senior Citizens:

If you provide the Department of Utilities with proof of your age and if you qualify (age 62 or older), you will receive a discount on the water portion only of your utility bill. If you have questions regarding the City’s Senior Citizen discount, please request a current water, sewer, and garbage rate chart from the Department of Utilities.

Delinquent Bill and Returned Check Policy:


If you fail to pay your utility bill and the bill is 60 days past due or if your bill is over $45.00 and past due, your service will be disconnected without notice. In order to have your service restored, you must pay your account balance in full and the City’s DISCONNECTION charge of $40.00. It is the City’s policy to terminate service without notice in response to all returned checks. A service charge of $25.00 plus the $40.00 disconnection fee will be charged for all returned checks.

Bad Debt:

If you file for bankruptcy and are unable to pay your bill, you will be required to re-establish service and pay an additional (new) deposit of $125.00.

If you vacate the premise and your deposit does not cover your final bill, the City will pursue collection of the remainder of the debt and may turn the account over to a collection agency, report each delinquent account to each of the three credit bureaus, and/or file a lien against your property.

Other legal action may be pursued by the City in an effort to collect the debt. Be advised that failure on your part to receive a utility bill does not excuse non-payment. In all cases, nonpayment will result in termination of service without notice.

NOTICE:

In order to complete your request to establish water and/or sewer and/or garbage service, you must submit a copy of your Drivers License or a Georgia Photo ID along with either Proof of Ownership of the property (deed) or a Rental/Lease Agreement along with this completed form.

If you have any questions please contact Cumming Utilities at 770-781-2020.

 

Cut-On Date:

Full Name :

Primary Contact Phone Number: 

Secondary Phone Number (Optional):

Email:

Service Address:

Mailing Address (if different than Service Address):

Subdivision Name & Lot Number:

Landlord Name and Phone (if leasing):

Preferred Billing Method:


Senior Citizen Discount:

MUST BE INITIALED BY ACCOUNT HOLDER TO RECEIVE DISCOUNT:

Image of your current driver's license:

Image of Proof of Ownership or Rental/Lease Agreement:


I HAVE READ, UNDERSTOOD AND AGREED TO THE ABOVE TERMS:

Leave this empty:

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Signature Certificate
Document name: Residential Service Application
lock iconUnique Document ID: 1f6f881e37b52dec6d6a7d4bfd2b03c754506c30
Timestamp Audit
May 24, 2019 11:13 am EDTResidential Service Application Uploaded by Cumming Utilities - steven@joomlahostingreviews.com IP 73.82.246.63
May 24, 2019 11:30 am EDTCumming Utilities - applications@cummingutilities.com added by Cumming Utilities - steven@joomlahostingreviews.com as a CC'd Recipient Ip: 73.82.246.63