Application for Water & Sewer Service | City of Nash

Move out date *

Account # *

Route # *

Sequence # *

Cert. of Dep # *

Number in household *

Name *

Spouse's name *

Driver's licence number and state *

Social Security number *

Home phone number *

Name of employer *

Cell phone number *

Supervisor *

Email *

Business phone number *

Address moving into *

Mailing Address *

Have you or your spouse ever had water service in Nash before? *

If yes, whose name was the service listed under and when did you have prior service?

Whose name is the electric and/or gas service listed under? *

List electric and gas with the respective name.

Landlord's Name *

Landlord's Phone Number *

Landlord's Address *

Personal references. Please List Two: (Name, Address and Phone Number) *

Signature *

Date *

City of Nash, TX

Customer account # *

Account name *

Service address *

City, Zip *

Phone number

Billing Address *

City, Zip

REL

Containers

Service

Signature *

Date *

Monthly Service Charges for Scheduled Services Will Be Deducted At Current Rate.

OUR BUDGET FOR THE 2021 YEAR