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Information for the Initiation of Waters Sewer/Trash Service

3. Information for the Initiation of Water Service/Trash Service

5. Last Name

6. First Name

7. Middle Initial

9. Address1

11. Billing Address if Different

13. City

14. State

15. Zip

17. Social Security Number

18. Driver's License/Date of Birth

    Number, Exp. Date, DOB

20. Daytime Phone Number

21. Other Phone

23. Service Start Date

    Water is turned on Monday - Friday Only

25. Have you had service with the City of Wichita Falls before?

27. Attach picture of ID*

    Application can not be processed without ID

29. Please Include: 1. The complete application form. 2. A copy of your driver's license. 3. Deposit must be paid in advance. 4. Completed application and deposit must be received by 4:30 PM for same business day service.

    Please Include: 1. The complete application form. 2. A copy of your driver's license. 3. Deposit must be paid in advance. 4. Completed application and deposit must be received by 4:30 PM for same business day service.

31. Mail to: City of Wichita Falls P.O. Box 1440 Wichita Falls, Texas 76307-7532

    Mail to: City of Wichita Falls P.O. Box 1440 Wichita Falls, Texas 76307-7532

32. Fax to: (940) 761-8879

    Fax to: (940) 761-8879

33. Deposits: Single-Family: $90.00 Commercial minimum $100 call for deposit amount.

    Deposits: Single-Family: $90.00 Commercial minimum $100 call for deposit amount.

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

* indicates a required field