First Name

Last Name

Choose One Choose One *Purchased / Owner

Service Address

Sevice City

Service State

Service Zip Code

Mailing Address (if different than service address)

Mailing City

Mailing State

Mailing Zip Code

Phone Number

Email Address

Preferred Contact Method Preferred Contact Method Phone Email

Attach the following documents Attach the following document: Legal Identification File InputChoose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, mka. Max. file size: 10 MB

Attach the following documents Attach the following document:Closing Disclosure Deed or Rental Agreement (must be signed documents) File InputChoose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, mka. Max. file size: 10 MB

I agree to the Templeton Water Terms and Conditions I agree to the Templeton Water Terms and Conditions I agree to the Templeton Water Terms and Conditions Terms and Conditions

I confirm that I am the legal owner of the property for which I am requesting water service. I confirm that I am the legal owner of the property for which I am requesting water service. I agree Upon application for service, all commercial and industrial customers and residential Customers who do not own the property at the service location shall be required to pay a security deposit. In general, residential rental customers shall furnish a security deposit equal to three months’ estimated usage provided however, such security deposit shall not exceed the amount permitted by applicable law. Commercial and industrial Customers shall furnish a security deposit equal to three months’ estimated usage. Under no set of circumstances shall any meter security deposit be less than $300.

Additional Comments

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