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New Account Setup Form

  1. Mailing Address
  2. Deposit type
    Renters are required to pay a fully refundable deposit. Deposits are refunded at account closing less any amount owed. Please select one of the above options.
  3. Demographic Information
    The Town's utility systems are funded in part by federal loans and grants that require the Town to collect and report demographic information about our customers to ensure services are being provided in a non-discriminatory fashion.
  4. Service Agreement
    The account holder agrees to pay monthly bills by the 20th of each month. If not paid on or before the 20th of the month a 10% penalty will apply. If payment is not received by the 29th of each month, service will subject to disconnection on the 30th. An administrative fee of $25 will apply when service is disconnected due to non-payment. The administrative fee, plus the past due amount must be paid before service is restored. Insufficient funds will result in a $25 fee. All fees and rates are subject to change by the Dobson Board of Commissioners. Tampering with meters or backflow devices, or violating ordinances related to water and sewer utilities may result in service termination. The account holder will be liable for any balance on the account until the account is terminated in writing by the account holder. The Town of Dobson may release information to collection services who may charge additional collection fees to account holder. The Town of Dobson is an equal opportunity provider.
  5. By typing your name you hereby agree to the above service agreement.
  6. Leave This Blank:

  7. This field is not part of the form submission.