Click Here to pay your water bill on line....

 

 

 

 

 

 

 
 

 
 
 
 

THIS IS A ENCRYPTED FORM ALL DATA SENT THROUGH THIS FORM IS SECURE 

CUSTOMER SERVICE FORM

 
 

Last Name:

   First Name:

Mailing Address

City, State, Zip

    

Service Address

Phone Number

   Cell Phone   Work Phone 

Drivers License

   Drivers License B:

Select One

 "Owner" or "Rent"    Social Security # XXX-XX-XXXX
Date to Begin Service 
On the Date Above, take the following action Unlock Means Cabot Waterworks will Unlock
the meter but will not turn the water ON.  (select - "Turn On", "Turn Off" or "Unlock Only")
 

List below all adults living at this address. Separate names with ","

 

Click here to view the Customer information Sheet.  Click to return
 

Read the Customer Information Sheet Above before you continue.

 
I have read, understand and agree to all of the previsions of this CUSTOMER INFORMATION SHEET and have answered each question here truthfully to the best of my knowledge. (Selecting "I AGREE" in the following  box, is in effect the same as if I have signed my name to this form.
 Select One:      Enter Today's date   enter date as (xx/xx/xx).
 
Place of Employment:
It is OK to turn the water "ON' if the customer is not present. Select one or Yes!
NOTICE: New customers have three days from the time the water is turned on come into our office and complete their new service.

Cabot Waterworks will NOT be responsible for water damage to your property.

 Please click when finished or to clear the form.